The impact of urinary albumin-creatinine ratio and glomerular filtration rate on long-term mortality in patients with heart failure: The National Health and Nutrition Examination Survey 1999-2018.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: Netherlands NLM ID: 9111474 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1590-3729 (Electronic) Linking ISSN: 09394753 NLM ISO Abbreviation: Nutr Metab Cardiovasc Dis Subsets: MEDLINE
    • Publication Information:
      Publication: 2005- : Amsterdam : Elsevier
      Original Publication: [Heidelberg] : Springer International, c1991-
    • Subject Terms:
      Heart Failure*/mortality ; Heart Failure*/physiopathology ; Heart Failure*/diagnosis ; Heart Failure*/urine ; Glomerular Filtration Rate* ; Albuminuria*/mortality ; Albuminuria*/diagnosis ; Albuminuria*/physiopathology ; Albuminuria*/urine ; Biomarkers*/urine ; Biomarkers*/blood ; Creatinine*/urine ; Nutrition Surveys* ; Predictive Value of Tests* ; Kidney*/physiopathology; Humans ; Male ; Female ; Aged ; Middle Aged ; Risk Assessment ; Time Factors ; Prognosis ; Risk Factors ; Republic of Korea/epidemiology ; Serum Albumin, Human
    • Abstract:
      Background and Aims: The urinary albumin‒creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) are important markers of renal dysfunction, but few studies have simultaneously examined their impact on long-term mortality in patients with heart failure (HF).
      Methods and Results: This study included patients with HF from the National Health and Nutrition Survey from 1999 to 2018. The fully adjusted Cox proportional risk model was adopted, and propensity score matching (PSM) was also used for risk adjustment. Among 988 patients, a median follow-up of 7.75 years was recorded. A higher UACR corresponded to a higher risk of cardiovascular death (P < 0.001 for trend). No statistically significant difference was found in the trend of eGFR risk stratification on the risk of cardiovascular death (P = 0.09 for trend). After PSM, the results showed that when grouped by UACR, the high-risk group had a higher risk of cardiovascular death regardless of a cutoff value of 30 or 300 mg/g (all P < 0.05). When grouped by eGFR, regardless of a cutoff value of 45 or 30 mL/min/1.73 m 2 , compared to the low-risk group, the high-risk group did not have a statistically significant increase in cardiovascular death (P = 0.086 and P = 0.093, respectively). The subgroup analysis of the main outcome showed an interaction between the UACR and eGFR (P = 0.044).
      Conclusions: Both the UACR and eGFR are markers for predicting the progression of HF, but the UACR may be a more important indicator than the eGFR, and they synergistically and complementarily reflect the long-term cardiovascular risk of HF patients.
      Competing Interests: Declaration of competing interest The authors declare that they have no confict of interest.
      (Copyright © 2024 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)
    • Contributed Indexing:
      Keywords: Glomerular filtration rate; Heart failure; Long-term cardiovascular risk; Propensity score matching; Urinary albumin‒creatinine ratio
    • Accession Number:
      0 (Biomarkers)
      AYI8EX34EU (Creatinine)
      0 (ALB protein, human)
      ZIF514RVZR (Serum Albumin, Human)
    • Publication Date:
      Date Created: 20240228 Date Completed: 20240523 Latest Revision: 20240523
    • Publication Date:
      20240524
    • Accession Number:
      10.1016/j.numecd.2024.01.016
    • Accession Number:
      38418348