On-admission proteinuria was independently associated with increased long-term mortality (HR 1.06; 95% CI 1.13-1.10) and mortality or heart failure hospitalization in patients with acute heart failure.
Cohort (n=2,476)
Does on-admission proteinuria predict long-term mortality and heart failure hospitalization in patients with acute heart failure?
On-admission proteinuria detected by a simple urine dipstick is an independent predictor of long-term mortality and heart failure hospitalization in patients with acute heart failure.
Estimación del efecto: HR 1.06 (95% CI 1.13-1.10)
Abstract Background Proteinuria has been associated with adverse clinical events in patients with chronic heart failure. However, prognostic value of proteinuria in patients with acute heart failure (AHF) remained to be elucidated. Methods The study population was drawn from HARVEST registry, which was composed of patients hospitalized due to AHF. Patients with estimated glomerular filtration rate (eGFR) less than 15 ml/min/1.73m2 were excluded. Proteinuria was measured by the urine dip stick test (UDT) on admission. Cardiovascular death and hospitalization due to heart failure were identified. The National Death Registry was linked to identify the clinical outcome of all-cause mortality and heart failure hospitalization (HFH) within a 10-year follow-up. Results Among a total of 2476 patients (74.1±12.9 years, 65.7% male), 1061 patients (42.9%) had proteinuria. Comparing to patients without proteinuria, those with proteinuria had more co-morbidities of diabetes, hypertension and chronic kidney disease. They also had lower levels of hemoglobin, eGFR and albumin but higher level of cholesterol and NT-proBNP. In multiple logistic regression analysis, atrial fibrillation, right ventricular systolic pressure, low eGFR and albumin were independently correlated with the presence of proteinuria. During a median follow-up duration of 31 months, 1034 (41.8%) patients had HFH and 1852 (74.8%) died. Survival curve analysis showed that the mortality rate increased with the presence of proteinuria. After accounting for age, sex, albumin level, and eGFR, proteinuria was associated with a higher mortality rate and mortality or HHF in the total study population (hazard ratio and 95% confidence intervals: 1.06, 1.13-1.10 and 1.05, 1.004-1.09, respectively). The associations remained true, regardless of diabetic status, left ventricular ejection fraction or eGFR. Conclusions On-admission proteinuria is independently associated with increased long-term mortality in patients with AHF, regardless of morbidities.
Chang et al. (Sat,) conducted a cohort in acute heart failure (n=2,476). Proteinuria vs. No proteinuria was evaluated on Mortality (HR 1.06, 95% CI 1.13-1.10). On-admission proteinuria was independently associated with increased long-term mortality (HR 1.06; 95% CI 1.13-1.10) and mortality or heart failure hospitalization in patients with acute heart failure.