Heart Failure: Low Prealbumin At Discharge Linked to Mortality

MedicalResearch.com Interview with:
Dr. Patrícia Lourenço
Serviço de Medicina Interna, Centro Hospitalar São João
Faculdade de Medicina da Universidade do Porto,
Unidade I&D Cardiovascular do Porto
Monteiro, Portugal;

Medical Research: What are the main findings of the study?

Dr. Lourenço: A low prealbumin at hospital discharge associates with morbidity and mortality in acute heart failure patients. The prognostic value of low prealbumin in heart failure is independent of other nutritional markers and of the inflammatory status.

Medical Research: Were any of the findings unexpected?

Dr. Lourenço: Prealbumin is an established marker of nutritional status and is a negative acute phase protein. Despite we cannot consider the results completely unexpected, the fact that prealbumin had an association with prognosis beyond the effect of the nutritional and inflammatory media suggests an intrinsic prognostic role for prealbumin in heart failure. The possibility that prealbumin has some detoxifying capacity is kept open apart from theorically possible.

Medical Research: What should clinicians and patients take away from your report?

Dr. Lourenço: Heart Failure can course with undernutrition in a multifactorial process. Heart Failure is a low grade inflammatory condition. The prealbumin value of an acute heart failure patient reflects nutrition and inflammation and it can be looked at as a marker of morbidity and mortality.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Lourenço: Probably the two main yet unanswered questions are:

1) What are the main pathophysiologycal mechanisms underlying the transition between normal weight to weight loss and cachexia establishment in heart failure patients ?;

2) Is there a place for therapeutic options intended to halt and/or reverse undernutrition in heart failure ? Further research should address these issues.


Low prealbumin is strongly associated with adverse outcome in heart failure

Patrícia Lourenço, Sérgio Silva, Fernando Friões, Margarida Alvelos, Marta Amorim, Marta Couto, Paulo Torres-Ramalho, João Tiago Guimarães, José Paulo Araújo, Paulo Bettencourt

Heart heartjnl-2014-305747Published Online First: 1 July 2014 doi:10.1136/heartjnl-2014-305747

Last Updated on July 4, 2014 by Marie Benz MD FAAD