albumin - publications

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1. Eur J Heart Fail. 2012 Jan 31. [Epub ahead of print]

Urinary albumin excretion in heart failure with preserved ejection fraction: an
interim analysis of the CHART 2 study.

Miura M, Shiba N, Nochioka K, Takada T, Takahashi J, Kohno H, Shimokawa H; on
behalf of the CHART-2 Investigators.

Department of Cardiovascular Medicine and Department of Evidence-based
Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai,
Japan.

AIMS: Heart failure with preserved ejection fraction (HFpEF) is characterized by
multiple co-morbidities, including chronic kidney disease that is one of the
prognostic risks for these patients. This study was performed to evaluate the
value of determination of albuminuria using a urine dipstick test (UDT), combined
with estimated glomerular filtration rate (eGFR), for predicition of mortality in
HFpEF. METHODS AND RESULTS: We enrolled 2465 consecutive patients with overt HF
with EF ≥50% in our Chronic Heart Failure Analysis and Registry in the Tohoku
District 2 (CHART-2) study (NCT00418041). We defined trace or more UDT as
positive. We divided the patients into the following four groups based on eGFR
and UDT; group 1 (G1) (eGFR ≥60, negative UDT), G2 (eGFR ≥60, positive UDT), G3
(eGFR <60, negative UDT), and G4 (eGFR <60, positive UDT). In total, 29.5% of the
HFpEF patients had a positive UDT. HFpEF patients with a positive UDT were
characterized by higher brain natriuretic peptide levels and frequent histories
of hypertension or diabetes. During a mean follow-up of 2.5 years, HFpEF patients
with a positive UDT showed higher mortality in each stratum of eGFR levels. A
multivariable adjusted Cox model showed that when compared with G1 (reference),
the hazard ratio of all-cause death for G2, G3, and G4 was 2.44 (95% confidence
interval 1.47-4.05, P=0.001), 1.43 (0.92-2.23, P=0.12), and 2.71 (1.72-4.27,
P<0.001), respectively. Furthermore, the prognostic value of a positive UDT was
robust for both cardiovascular and non-cardiovascular deaths. CONCLUSIONS: These
results indicate that measurement of albuminuria in addition to eGFR is useful
for appropriate risk stratification in HFpEF patients.

PMID: 22298637 [PubMed - as supplied by publisher]