ISSN 1016-5169 | E-ISSN 1308-4488
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Effect of Albumin-Bilirubin Score on Prognosis in Ambulatory Heart Failure Patients with Reduced Ejection Fraction [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2024; 52(2): 96-102 | DOI: 10.5543/tkda.2023.04488

Effect of Albumin-Bilirubin Score on Prognosis in Ambulatory Heart Failure Patients with Reduced Ejection Fraction

Aylin Sungur1, Mustafa Azmi Sungur2, Özlem Yıldırımtürk2
1Department of Cardiology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Türkiye
2Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Türkiye


OBJECTIVE
Heart failure (HF) often impacts liver function due to reduced cardiac output and increased venous congestion. The Albumin-Bilirubin (ALBI) score has recently been shown to possess prognostic value in patients hospitalized with HF. In this study, we aimed to evaluate the association of the ALBI score with long-term mortality in ambulatory HF patients with reduced ejection fraction (HFrEF).


METHOD
Consecutive patients with HFrEF were included between 2014 and 2019. The ALBI score was calculated using the following formula: (log10 total bilirubin [mg/dL] × 0.66) + (albumin [g/dL] × -0.085). Patients were categorized into two groups: low ALBI (≤ -2.60) and high ALBI score (> -2.60). The endpoint was all-cause mortality. Patients were followed up for a median of 55 (42.6-68.4) months.


RESULTS
A total of 417 patients were included in the study. The mean age of the group was 51.5 ± 11.9 years, 74.8% were male, and 36.5% (n = 152) of the patients were in the high ALBI score group. Patients with a high ALBI score were more likely to be in the New York Heart Association functional class III/IV. These patients had significantly higher N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, systolic pulmonary arterial pressure, and inferior vena cava diameter, along with worse right ventricular systolic function than patients with a low ALBI score. All-cause mortality was significantly increased in the high ALBI score group (41.4% vs. 27.2%, P = 0.003). Multivariate analysis revealed the ALBI score (HR 1.53, 95% CI 1.09-2.15, P = 0.02) as an independent predictor of long-term mortality.


CONCLUSION
The ALBI score is associated with increased long-term mortality in outpatients with HFrEF. It can easily be evaluated and utilized as a liver dysfunction score in this patient group, providing prognostic information.

Keywords: Albumin-bilirubin score, heart failure with reduced ejection fraction, mortality

How to cite this article
Aylin Sungur, Mustafa Azmi Sungur, Özlem Yıldırımtürk. Effect of Albumin-Bilirubin Score on Prognosis in Ambulatory Heart Failure Patients with Reduced Ejection Fraction. Turk Kardiyol Dern Ars. 2024; 52(2): 96-102

Corresponding Author: Aylin Sungur, Türkiye
Manuscript Language: English


Journal Metrics

Journal Citation Indicator: 0.18
CiteScore: 1.1
Source Normalized Impact
per Paper:
0.22
SCImago Journal Rank: 0.348

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