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Liver function abno...
Liver function abnormalities and outcome in patients with chronic heart failure: data from the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) program
- Article/chapterEnglish2009
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LIBRIS-ID:oai:gup.ub.gu.se/95479
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https://gup.ub.gu.se/publication/95479URI
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https://doi.org/10.1093/eurjhf/hfn031DOI
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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AIMS: The prevalence and importance of liver function test (LFT) abnormalities in a large contemporary cohort of heart failure patients have not been systematically evaluated. METHODS AND RESULTS: We characterized the LFTs of 2679 patients with symptomatic chronic heart failure from the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity program (CHARM). We used multivariable modelling to assess the relationships between baseline LFT values and long-term outcomes. Liver function test abnormalities were common in patients with chronic heart failure, ranging from alanine aminotransferase elevation in 3.1% of patients to low albumin in 18.3% of patients; total bilirubin was elevated in 13.0% of patients. In multivariable analysis, elevated total bilirubin was the strongest LFT predictor of adverse outcome for both the composite outcome of cardiovascular death or heart failure hospitalization (HR 1.21 per 1 SD increase, P<0.0001) and all-cause mortality (HR 1.19 per 1 SD increase, P<0.0001). Even after adjustment for other variables, elevated total bilirubin was one of the strongest independent predictors of poor prognosis (by global chi-square). CONCLUSION: Bilirubin is independently associated with morbidity and mortality. Changes in total bilirubin may offer insight into the underlying pathophysiology of chronic heart failure.
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Felker, G. M.
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Pocock, S.
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McMurray, J. J.
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Pfeffer, M. A.
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Swedberg, Karl,1944Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine(Swepub:gu)xsweka
(author)
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Wang, D.
(author)
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Yusuf, S.
(author)
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Michelson, E. L.
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Granger, C. B.
(author)
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Göteborgs universitetInstitutionen för medicin, avdelningen för akut och kardiovaskulär medicin
(creator_code:org_t)
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In:Eur J Heart Fail: Wiley11:2, s. 170-71388-9842
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Allen, L. A.
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Felker, G. M.
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Pocock, S.
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McMurray, J. J.
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Pfeffer, M. A.
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Swedberg, Karl, ...
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show more...
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Wang, D.
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Yusuf, S.
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Michelson, E. L.
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Granger, C. B.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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Eur J Heart Fail
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University of Gothenburg