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Göteborgs universitets publikationer

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

Författare och institution:
L. A. Allen (-); G. M. Felker (-); S. Pocock (-); J. J. McMurray (-); M. A. Pfeffer (-); Karl Swedberg (Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin); D. Wang (-); S. Yusuf (-); E. L. Michelson (-); C. B. Granger (-)
Publicerad i:
Eur J Heart Fail, 11 ( 2 ) s. 170-7
1388-9842 (Print)
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
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.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Klinisk medicin ->
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
Postens nummer:
Posten skapad:
2009-07-02 10:39

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