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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
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Allen, L. A. (author)
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Felker, G. M. (author)
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Pocock, S. (author)
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McMurray, J. J. (author)
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Pfeffer, M. A. (author)
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- Swedberg, Karl, 1944 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine
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Wang, D. (author)
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Yusuf, S. (author)
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Michelson, E. L. (author)
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Granger, C. B. (author)
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(creator_code:org_t)
- 2009-01-28
- 2009
- English.
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In: Eur J Heart Fail. - : Wiley. - 1388-9842. ; 11:2, s. 170-7
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Abstract
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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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Aged
- Alanine Transaminase/blood
- Alkaline Phosphatase/blood
- Aspartate Aminotransferases/blood
- Bilirubin/blood
- Chronic Disease
- Female
- Heart Failure/complications/mortality/*physiopathology
- Hospitalization
- Humans
- Liver Diseases/complications/diagnosis
- *Liver Function Tests
- Male
- Middle Aged
- Prognosis
- Proportional Hazards Models
- Serum Albumin/analysis
- Ventricular Function
- Left
Publication and Content Type
- ref (subject category)
- art (subject category)
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To the university's database
- By the author/editor
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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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show less...
- 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 ...
- Articles in the publication
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Eur J Heart Fail
- By the university
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University of Gothenburg