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Göteborgs universitets publikationer

Clinical course and predictive value of liver function tests in patients hospitalized for worsening heart failure with reduced ejection fraction: an analysis of the EVEREST trial

Författare och institution:
A. P. Ambrosy (-); M. Vaduganathan (-); M. D. Huffman (-); S. Khan (-); M. J. Kwasny (-); A. J. Fought (-); A. P. Maggioni (-); Karl Swedberg (Institutionen för medicin, avdelningen för molekylär och klinisk medicin); M. A. Konstam (-); F. Zannad (-); M. Gheorghiade (-)
Publicerad i:
European journal of heart failure, 14 ( 3 ) s. 302-311
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
AIMS: Abnormal liver function tests (LFTs) are common in ambulatory heart failure (HF). The aim of this study was to characterize abnormal LFTs during index hospitalization. METHODS AND RESULTS: A post-hoc analysis was carried out of the placebo group of the EVEREST (Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan) trial, which enrolled patients hospitalized for HF with an ejection fraction (EF) 34 IU/L), alanine transaminase (ALT, >34 IU/L), alkaline phosphatase (AP, >123 IU/L),gamma-glutamyl transferase (GGT, >50 IU/L), and total bilirubin (T Bili, >1.2 mg/dL) were measured at baseline, discharge/day 7, and post-discharge. Co-primary endpoints were all-cause mortality (ACM) and cardiovascular mortality or first HF hospitalization (CVM + HFH). Study participants had a mean age of 65.6 +/-12.0 years, were mostly male, reported high prevalences of medical co-morbidities, and were well treated with evidence-based therapies. Baseline LFT abnormalities were common (ALB 17%, AST 21%, ALT 21%, AP 23%, GGT 62%, and T Bili 26%). Abnormal T Bili was the only marker to decrease substantially from baseline (26%) to discharge/day 7 (19%). All LFTs, except AP, improved post-discharge. Lower baseline ALB and elevated T Bili were associated with higher rates of ACM, and in-hospital decreases in ALB and increases in T Bili were associated with higher rates of both ACM and CVM + HFH. CONCLUSION: LFT abnormalities are common during hospitalization for HF in patients with reduced EF and were persistent at discharge. Baseline and in-hospital changes in ALB and T Bili provide additional prognostic value.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Klinisk medicin
Heart failure, Liver function test, Albumin, Alanine transaminase, Aspartate transaminase, Alkaline phosphatase, γ-Glutamyl transferase, Bilirubin
Postens nummer:
Posten skapad:
2012-05-23 11:08
Posten ändrad:
2016-06-10 12:09

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