Hypoalbuminaemia predicts outcome in adult patients with congenital heart disease
Identifieur interne : 000293 ( Ncbi/Merge ); précédent : 000292; suivant : 000294Hypoalbuminaemia predicts outcome in adult patients with congenital heart disease
Auteurs : Aleksander Kempny [Royaume-Uni, Allemagne] ; Gerhard-Paul Diller [Royaume-Uni, Allemagne] ; Rafael Alonso-Gonzalez [Royaume-Uni] ; Anselm Uebing [Royaume-Uni] ; Isma Rafiq [Royaume-Uni] ; Wei Li [Royaume-Uni] ; Lorna Swan [Royaume-Uni] ; James Hooper [Royaume-Uni] ; Jackie Donovan [Royaume-Uni] ; Stephen J. Wort [Royaume-Uni] ; Michael A. Gatzoulis [Royaume-Uni] ; Konstantinos Dimopoulos [Royaume-Uni]Source :
- Heart [ 1355-6037 ] ; 2015.
Abstract
In patients with acquired heart failure, hypoalbuminaemia is associated with increased risk of death. The prevalence of hypoproteinaemia and hypoalbuminaemia and their relation to outcome in adult patients with congenital heart disease (ACHD) remains, however, unknown.
Data on patients with ACHD who underwent blood testing in our centre within the last 14 years were collected. The relation between laboratory, clinical or demographic parameters at baseline and mortality was assessed using Cox proportional hazards regression analysis.
A total of 2886 patients with ACHD were included. Mean age was 33.3 years (23.6–44.7) and 50.1% patients were men. Median plasma albumin concentration was 41.0 g/L (38.0–44.0), whereas hypoalbuminaemia (<35 g/L) was present in 13.9% of patients. The prevalence of hypoalbuminaemia was significantly higher in patients with great complexity ACHD (18.2%) compared with patients with moderate (11.3%) or simple ACHD lesions (12.1%, p<0.001). During a median follow-up of 5.7 years (3.3–9.6), 327 (11.3%) patients died. On univariable Cox regression analysis, hypoalbuminaemia was a strong predictor of outcome (HR 3.37, 95% CI 2.67 to 4.25, p<0.0001). On multivariable Cox regression, after adjusting for age, sodium and creatinine concentration, liver dysfunction, functional class and disease complexity, hypoalbuminaemia remained a significant predictor of death.
Hypoalbuminaemia is common in patients with ACHD and is associated with a threefold increased risk of risk of death. Hypoalbuminaemia, therefore, should be included in risk-stratification algorithms as it may assist management decisions and timing of interventions in the growing ACHD population.
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DOI: 10.1136/heartjnl-2014-306970
PubMed: 25736048
PubMed Central: 4413739
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strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Donovan, Jackie" sort="Donovan, Jackie" uniqKey="Donovan J" first="Jackie" last="Donovan">Jackie Donovan</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Wort, Stephen J" sort="Wort, Stephen J" uniqKey="Wort S" first="Stephen J" last="Wort">Stephen J. Wort</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Gatzoulis, Michael A" sort="Gatzoulis, Michael A" uniqKey="Gatzoulis M" first="Michael A" last="Gatzoulis">Michael A. Gatzoulis</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Dimopoulos, Konstantinos" sort="Dimopoulos, Konstantinos" uniqKey="Dimopoulos K" first="Konstantinos" last="Dimopoulos">Konstantinos Dimopoulos</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25736048</idno><idno type="pmc">4413739</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4413739</idno><idno type="RBID">PMC:4413739</idno><idno type="doi">10.1136/heartjnl-2014-306970</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000041</idno><idno type="wicri:Area/Pmc/Curation">000041</idno><idno type="wicri:Area/Pmc/Checkpoint">000131</idno><idno type="wicri:Area/Ncbi/Merge">000293</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Hypoalbuminaemia predicts outcome in adult patients with congenital heart disease</title><author><name sortKey="Kempny, Aleksander" sort="Kempny, Aleksander" uniqKey="Kempny A" first="Aleksander" last="Kempny">Aleksander Kempny</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Department of Cardiology and Angiology</addr-line>,<institution>Adult Congenital and Valvular Heart Disease Center, University Hospital of Münster</institution>,<addr-line>Muenster</addr-line>,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Diller, Gerhard Paul" sort="Diller, Gerhard Paul" uniqKey="Diller G" first="Gerhard-Paul" last="Diller">Gerhard-Paul Diller</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Department of Cardiology and Angiology</addr-line>,<institution>Adult Congenital and Valvular Heart Disease Center, University Hospital of Münster</institution>,<addr-line>Muenster</addr-line>,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Alonso Gonzalez, Rafael" sort="Alonso Gonzalez, Rafael" uniqKey="Alonso Gonzalez R" first="Rafael" last="Alonso-Gonzalez">Rafael Alonso-Gonzalez</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Uebing, Anselm" sort="Uebing, Anselm" uniqKey="Uebing A" first="Anselm" last="Uebing">Anselm Uebing</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Rafiq, Isma" sort="Rafiq, Isma" uniqKey="Rafiq I" first="Isma" last="Rafiq">Isma Rafiq</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Li, Wei" sort="Li, Wei" uniqKey="Li W" first="Wei" last="Li">Wei Li</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Swan, Lorna" sort="Swan, Lorna" uniqKey="Swan L" first="Lorna" last="Swan">Lorna Swan</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Hooper, James" sort="Hooper, James" uniqKey="Hooper J" first="James" last="Hooper">James Hooper</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Donovan, Jackie" sort="Donovan, Jackie" uniqKey="Donovan J" first="Jackie" last="Donovan">Jackie Donovan</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Wort, Stephen J" sort="Wort, Stephen J" uniqKey="Wort S" first="Stephen J" last="Wort">Stephen J. Wort</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Gatzoulis, Michael A" sort="Gatzoulis, Michael A" uniqKey="Gatzoulis M" first="Michael A" last="Gatzoulis">Michael A. Gatzoulis</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Dimopoulos, Konstantinos" sort="Dimopoulos, Konstantinos" uniqKey="Dimopoulos K" first="Konstantinos" last="Dimopoulos">Konstantinos Dimopoulos</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">Heart</title><idno type="ISSN">1355-6037</idno><idno type="eISSN">1468-201X</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>In patients with acquired heart failure, hypoalbuminaemia is associated with increased risk of death. The prevalence of hypoproteinaemia and hypoalbuminaemia and their relation to outcome in adult patients with congenital heart disease (ACHD) remains, however, unknown.</p></sec><sec><title>Methods</title><p>Data on patients with ACHD who underwent blood testing in our centre within the last 14 years were collected. The relation between laboratory, clinical or demographic parameters at baseline and mortality was assessed using Cox proportional hazards regression analysis.</p></sec><sec><title>Results</title><p>A total of 2886 patients with ACHD were included. Mean age was 33.3 years (23.6–44.7) and 50.1% patients were men. Median plasma albumin concentration was 41.0 g/L (38.0–44.0), whereas hypoalbuminaemia (<35 g/L) was present in 13.9% of patients. The prevalence of hypoalbuminaemia was significantly higher in patients with great complexity ACHD (18.2%) compared with patients with moderate (11.3%) or simple ACHD lesions (12.1%, p<0.001). During a median follow-up of 5.7 years (3.3–9.6), 327 (11.3%) patients died. On univariable Cox regression analysis, hypoalbuminaemia was a strong predictor of outcome (HR 3.37, 95% CI 2.67 to 4.25, p<0.0001). On multivariable Cox regression, after adjusting for age, sodium and creatinine concentration, liver dysfunction, functional class and disease complexity, hypoalbuminaemia remained a significant predictor of death.</p></sec><sec><title>Conclusions</title><p>Hypoalbuminaemia is common in patients with ACHD and is associated with a threefold increased risk of risk of death. Hypoalbuminaemia, therefore, should be included in risk-stratification algorithms as it may assist management decisions and timing of interventions in the growing ACHD population.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Verheugt, Cl" uniqKey="Verheugt C">CL Verheugt</name></author><author><name sortKey="Uiterwaal, Cs" uniqKey="Uiterwaal C">CS Uiterwaal</name></author><author><name sortKey="Van Der Velde, Et" uniqKey="Van Der Velde E">ET van der Velde</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dimopoulos, K" uniqKey="Dimopoulos K">K Dimopoulos</name></author><author><name sortKey="Diller, Gp" uniqKey="Diller G">GP Diller</name></author><author><name sortKey="Koltsida, E" uniqKey="Koltsida E">E Koltsida</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dimopoulos, K" uniqKey="Dimopoulos K">K Dimopoulos</name></author><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Heart</journal-id><journal-id journal-id-type="iso-abbrev">Heart</journal-id><journal-id journal-id-type="hwp">heartjnl</journal-id><journal-id journal-id-type="publisher-id">heart</journal-id><journal-title-group><journal-title>Heart</journal-title></journal-title-group><issn pub-type="ppub">1355-6037</issn><issn pub-type="epub">1468-201X</issn><publisher><publisher-name>BMJ Publishing Group</publisher-name><publisher-loc>BMA House, Tavistock Square, London, WC1H 9JR</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25736048</article-id><article-id pub-id-type="pmc">4413739</article-id><article-id pub-id-type="publisher-id">heartjnl-2014-306970</article-id><article-id pub-id-type="doi">10.1136/heartjnl-2014-306970</article-id><article-categories><subj-group subj-group-type="heading"><subject>Congenital Heart Disease</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>1506</subject><subject>1250</subject></subj-group><series-title>Original article</series-title></article-categories><title-group><article-title>Hypoalbuminaemia predicts outcome in adult patients with congenital heart disease</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kempny</surname><given-names>Aleksander</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref><xref ref-type="aff" rid="af3">3</xref><xref ref-type="aff" rid="af4">4</xref></contrib><contrib contrib-type="author"><name><surname>Diller</surname><given-names>Gerhard-Paul</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref><xref ref-type="aff" rid="af3">3</xref><xref ref-type="aff" rid="af4">4</xref></contrib><contrib contrib-type="author"><name><surname>Alonso-Gonzalez</surname><given-names>Rafael</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Uebing</surname><given-names>Anselm</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Rafiq</surname><given-names>Isma</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Li</surname><given-names>Wei</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Swan</surname><given-names>Lorna</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Hooper</surname><given-names>James</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Donovan</surname><given-names>Jackie</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Wort</surname><given-names>Stephen J</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Gatzoulis</surname><given-names>Michael A</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Dimopoulos</surname><given-names>Konstantinos</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref><xref ref-type="aff" rid="af3">3</xref></contrib></contrib-group><aff id="af1"><label>1</label><institution>Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital</institution>,<addr-line>London</addr-line>,<country>UK</country></aff><aff id="af2"><label>2</label><addr-line>NIHR Cardiovascular Biomedical Research Unit</addr-line>,<institution>Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></aff><aff id="af3"><label>3</label><institution>National Heart and Lung Institute, Imperial College School of Medicine</institution>,<addr-line>London</addr-line>,<country>UK</country></aff><aff id="af4"><label>4</label><addr-line>Department of Cardiology and Angiology</addr-line>,<institution>Adult Congenital and Valvular Heart Disease Center, University Hospital of Münster</institution>,<addr-line>Muenster</addr-line>,<country>Germany</country></aff><author-notes><corresp><label>Correspondence to</label> Dr Aleksander Kempny, Adult Congenital Heart Centre, Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, SW3 6NP London, UK; <email>a.kempny@rbht.nhs.uk</email></corresp></author-notes><pub-date pub-type="ppub"><day>1</day><month>5</month><year>2015</year></pub-date><pub-date pub-type="epub"><day>3</day><month>3</month><year>2015</year></pub-date><volume>101</volume><issue>9</issue><fpage>699</fpage><lpage>705</lpage><history><date date-type="received"><day>13</day><month>10</month><year>2014</year></date><date date-type="rev-recd"><day>31</day><month>1</month><year>2015</year></date><date date-type="accepted"><day>2</day><month>2</month><year>2015</year></date></history><permissions><copyright-statement>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</copyright-statement><copyright-year>2015</copyright-year><license license-type="open-access"><license-p>This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link></license-p></license></permissions><self-uri xlink:title="pdf" xlink:href="heartjnl-2014-306970.pdf"></self-uri><abstract><sec><title>Background</title><p>In patients with acquired heart failure, hypoalbuminaemia is associated with increased risk of death. The prevalence of hypoproteinaemia and hypoalbuminaemia and their relation to outcome in adult patients with congenital heart disease (ACHD) remains, however, unknown.</p></sec><sec><title>Methods</title><p>Data on patients with ACHD who underwent blood testing in our centre within the last 14 years were collected. The relation between laboratory, clinical or demographic parameters at baseline and mortality was assessed using Cox proportional hazards regression analysis.</p></sec><sec><title>Results</title><p>A total of 2886 patients with ACHD were included. Mean age was 33.3 years (23.6–44.7) and 50.1% patients were men. Median plasma albumin concentration was 41.0 g/L (38.0–44.0), whereas hypoalbuminaemia (<35 g/L) was present in 13.9% of patients. The prevalence of hypoalbuminaemia was significantly higher in patients with great complexity ACHD (18.2%) compared with patients with moderate (11.3%) or simple ACHD lesions (12.1%, p<0.001). During a median follow-up of 5.7 years (3.3–9.6), 327 (11.3%) patients died. On univariable Cox regression analysis, hypoalbuminaemia was a strong predictor of outcome (HR 3.37, 95% CI 2.67 to 4.25, p<0.0001). On multivariable Cox regression, after adjusting for age, sodium and creatinine concentration, liver dysfunction, functional class and disease complexity, hypoalbuminaemia remained a significant predictor of death.</p></sec><sec><title>Conclusions</title><p>Hypoalbuminaemia is common in patients with ACHD and is associated with a threefold increased risk of risk of death. Hypoalbuminaemia, therefore, should be included in risk-stratification algorithms as it may assist management decisions and timing of interventions in the growing ACHD population.</p></sec></abstract><custom-meta-group><custom-meta><meta-name>special-feature</meta-name><meta-value>unlocked</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Allemagne</li><li>Royaume-Uni</li></country></list><tree><country name="Royaume-Uni"><noRegion><name sortKey="Kempny, Aleksander" sort="Kempny, Aleksander" uniqKey="Kempny A" first="Aleksander" last="Kempny">Aleksander Kempny</name></noRegion><name sortKey="Alonso Gonzalez, Rafael" sort="Alonso Gonzalez, Rafael" uniqKey="Alonso Gonzalez R" first="Rafael" last="Alonso-Gonzalez">Rafael Alonso-Gonzalez</name><name sortKey="Alonso Gonzalez, Rafael" sort="Alonso Gonzalez, Rafael" uniqKey="Alonso Gonzalez R" first="Rafael" last="Alonso-Gonzalez">Rafael Alonso-Gonzalez</name><name sortKey="Alonso Gonzalez, Rafael" sort="Alonso Gonzalez, Rafael" uniqKey="Alonso Gonzalez R" first="Rafael" last="Alonso-Gonzalez">Rafael Alonso-Gonzalez</name><name sortKey="Diller, Gerhard Paul" sort="Diller, Gerhard Paul" uniqKey="Diller G" first="Gerhard-Paul" last="Diller">Gerhard-Paul Diller</name><name sortKey="Diller, Gerhard Paul" sort="Diller, Gerhard Paul" uniqKey="Diller G" first="Gerhard-Paul" last="Diller">Gerhard-Paul Diller</name><name sortKey="Diller, Gerhard Paul" sort="Diller, Gerhard Paul" uniqKey="Diller G" first="Gerhard-Paul" last="Diller">Gerhard-Paul Diller</name><name sortKey="Dimopoulos, Konstantinos" sort="Dimopoulos, Konstantinos" uniqKey="Dimopoulos K" first="Konstantinos" last="Dimopoulos">Konstantinos Dimopoulos</name><name sortKey="Dimopoulos, Konstantinos" sort="Dimopoulos, Konstantinos" uniqKey="Dimopoulos K" first="Konstantinos" last="Dimopoulos">Konstantinos Dimopoulos</name><name sortKey="Dimopoulos, Konstantinos" sort="Dimopoulos, Konstantinos" uniqKey="Dimopoulos K" first="Konstantinos" last="Dimopoulos">Konstantinos Dimopoulos</name><name sortKey="Donovan, Jackie" sort="Donovan, Jackie" uniqKey="Donovan J" first="Jackie" last="Donovan">Jackie Donovan</name><name sortKey="Donovan, Jackie" sort="Donovan, Jackie" uniqKey="Donovan J" first="Jackie" last="Donovan">Jackie Donovan</name><name sortKey="Donovan, Jackie" sort="Donovan, Jackie" uniqKey="Donovan J" first="Jackie" last="Donovan">Jackie Donovan</name><name sortKey="Gatzoulis, Michael A" sort="Gatzoulis, Michael A" uniqKey="Gatzoulis M" first="Michael A" last="Gatzoulis">Michael A. Gatzoulis</name><name sortKey="Gatzoulis, Michael A" sort="Gatzoulis, Michael A" uniqKey="Gatzoulis M" first="Michael A" last="Gatzoulis">Michael A. Gatzoulis</name><name sortKey="Gatzoulis, Michael A" sort="Gatzoulis, Michael A" uniqKey="Gatzoulis M" first="Michael A" last="Gatzoulis">Michael A. Gatzoulis</name><name sortKey="Hooper, James" sort="Hooper, James" uniqKey="Hooper J" first="James" last="Hooper">James Hooper</name><name sortKey="Hooper, James" sort="Hooper, James" uniqKey="Hooper J" first="James" last="Hooper">James Hooper</name><name sortKey="Hooper, James" sort="Hooper, James" uniqKey="Hooper J" first="James" last="Hooper">James Hooper</name><name sortKey="Kempny, Aleksander" sort="Kempny, Aleksander" uniqKey="Kempny A" first="Aleksander" last="Kempny">Aleksander Kempny</name><name sortKey="Kempny, Aleksander" sort="Kempny, Aleksander" uniqKey="Kempny A" first="Aleksander" last="Kempny">Aleksander Kempny</name><name sortKey="Li, Wei" sort="Li, Wei" uniqKey="Li W" first="Wei" last="Li">Wei Li</name><name sortKey="Li, Wei" sort="Li, Wei" uniqKey="Li W" first="Wei" last="Li">Wei Li</name><name sortKey="Li, Wei" sort="Li, Wei" uniqKey="Li W" first="Wei" last="Li">Wei Li</name><name sortKey="Rafiq, Isma" sort="Rafiq, Isma" uniqKey="Rafiq I" first="Isma" last="Rafiq">Isma Rafiq</name><name sortKey="Rafiq, Isma" sort="Rafiq, Isma" uniqKey="Rafiq I" first="Isma" last="Rafiq">Isma Rafiq</name><name sortKey="Swan, Lorna" sort="Swan, Lorna" uniqKey="Swan L" first="Lorna" last="Swan">Lorna Swan</name><name sortKey="Swan, Lorna" sort="Swan, Lorna" uniqKey="Swan L" first="Lorna" last="Swan">Lorna Swan</name><name sortKey="Swan, Lorna" sort="Swan, Lorna" uniqKey="Swan L" first="Lorna" last="Swan">Lorna Swan</name><name sortKey="Uebing, Anselm" sort="Uebing, Anselm" uniqKey="Uebing A" first="Anselm" last="Uebing">Anselm Uebing</name><name sortKey="Uebing, Anselm" sort="Uebing, Anselm" uniqKey="Uebing A" first="Anselm" last="Uebing">Anselm Uebing</name><name sortKey="Uebing, Anselm" sort="Uebing, Anselm" uniqKey="Uebing A" first="Anselm" last="Uebing">Anselm Uebing</name><name sortKey="Wort, Stephen J" sort="Wort, Stephen J" uniqKey="Wort S" first="Stephen J" last="Wort">Stephen J. Wort</name><name sortKey="Wort, Stephen J" sort="Wort, Stephen J" uniqKey="Wort S" first="Stephen J" last="Wort">Stephen J. Wort</name><name sortKey="Wort, Stephen J" sort="Wort, Stephen J" uniqKey="Wort S" first="Stephen J" last="Wort">Stephen J. Wort</name></country><country name="Allemagne"><noRegion><name sortKey="Kempny, Aleksander" sort="Kempny, Aleksander" uniqKey="Kempny A" first="Aleksander" last="Kempny">Aleksander Kempny</name></noRegion><name sortKey="Diller, Gerhard Paul" sort="Diller, Gerhard Paul" uniqKey="Diller G" first="Gerhard-Paul" last="Diller">Gerhard-Paul Diller</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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