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Escore Albumina-Bilirrubina para Predizer Desfechos em Pacientes com Cardiomiopatia Dilatada Idiopática / Albumin-Bilirubin Score to Predict Outcomes in Patients with Idiopathic Dilated Cardiomyopathy
Jiang, Mei; Wei, Xue-biao; Huang, Jie-leng; Su, Ze-da-zhong; Lin, Ying-wen; Yu, Dan-qing.
  • Jiang, Mei; Southern Medical University. The Second School of Clinical Medicine. Guangzhou. CN
  • Wei, Xue-biao; Guangdong Provincial Peoples Hospital. Guangdong Provincial Geriatrics Institute. Department of Geriatric Intensive Medicine. Guangzhou. CN
  • Huang, Jie-leng; Guangdong Provincial Peoples Hospital. Guangdong Cardiovascular Institute. Department of Cardiology. Guangzhou. CN
  • Su, Ze-da-zhong; Guangdong Provincial Peoples Hospital. Guangdong Cardiovascular Institute. Department of Cardiology. Guangzhou. CN
  • Lin, Ying-wen; Guangdong Provincial Peoples Hospital. Guangdong Cardiovascular Institute. Department of Cardiology. Guangzhou. CN
  • Yu, Dan-qing; Southern Medical University. The Second School of Clinical Medicine. Guangzhou. CN
Arq. bras. cardiol ; 118(6): 1108-1115, Maio 2022. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1383708
RESUMO
Resumo Fundamento A disfunção hepática é uma variável postulada de prognóstico desfavorável na cardiomiopatia dilatada (CMD).

Objetivo:

Este estudo teve como objetivo investigar o valor prognóstico do escore albumina-bilirrubina (ALBI), um modelo relativamente novo para a avaliação da função hepática, em pacientes com CMD idiopática.

Métodos:

Um total de 1.025 pacientes com CMD idiopática foram incluídos retrospectivamente e divididos em três grupos com base nos escores de ALBI grau 1 (≤ −2,60, n = 113), grau 2 (−2,60 a −1,39, n = 835) e grau 3 (> −1,39, n = 77). Foi analisada a associação do escore ALBI com eventos clínicos adversos maiores (ECAM) intra-hospitalares e mortalidade a longo prazo. Valor de p inferior a 0,05 foi considerado estatisticamente significativo.

Resultados:

A taxa de ECAM intra-hospitalares foi significativamente maior nos pacientes com grau 3 (2,7% versus 7,1% versus 24,7%, p < 0,001). A análise multivariada mostrou que o escore ALBI foi um preditor independente para ECAM intra-hospitalares (odds ratio ajustada = 2,80, IC 95% 1,63 - 4,80, p < 0,001). Após seguimento mediano de 27 meses, 146 (14,2%) pacientes morreram. A curva de Kaplan-Meier indicou que a taxa cumulativa de sobrevida a longo prazo foi significativamente menor em pacientes com grau mais alto de ALBI (log-rank = 45,50, p < 0,001). O escore ALBI foi independentemente associado à mortalidade a longo prazo (hazard ratio ajustada = 2,84, IC 95% 1,95 - 4,13, p < 0,001).

Conclusão:

O escore ALBI, como modelo de risco simples, pode ser considerado uma ferramenta de estratificação de risco para pacientes com CMD idiopática.
ABSTRACT
Abstract

Background:

Liver dysfunction is a postulated variable for poor prognosis in dilated cardiomyopathy (DCM).

Objective:

This study aimed to investigate the prognostic value of the albumin-bilirubin (ALBI) score, a relatively new model for evaluating liver function, in patients with idiopathic DCM.

Methods:

A total of 1025 patients with idiopathic DCM were retrospectively included and divided into three groups based on ALBI scores grade 1 (≤ −2.60, n = 113), grade 2 (−2.60 to −1.39, n = 835), and grade 3 (> −1.39, n = 77). The association of ALBI score with in-hospital major adverse clinical events (MACEs) and long-term mortality was analyzed. P-value less than 0.05 was considered statistically significant.

Results:

The in-hospital MACEs rate was significantly higher in the grade 3 patients (2.7% versus 7.1% versus 24.7%, p < 0.001). Multivariate analysis showed that ALBI score was an independent predictor for in-hospital MACEs (adjusted odds ratio = 2.80, 95%CI 1.63 - 4.80, p < 0.001). After a median 27-month follow-up, 146 (14.2%) patients died. The Kaplan-Meier curve indicated that the cumulative rate of long-term survival was significantly lower in patients with higher ALBI grade (log-rank = 45.50, p < 0.001). ALBI score was independently associated with long-term mortality (adjusted hazard ratio = 2.84, 95%CI 1.95 - 4.13, p < 0.001).

Conclusion:

ALBI score as a simple risk model could be considered a risk-stratifying tool for patients with idiopathic DCM.


Full text: Available Index: LILACS (Americas) Type of study: Prognostic study / Risk factors Language: Portuguese Journal: Arq. bras. cardiol Journal subject: Cardiology Year: 2022 Type: Article / Project document Affiliation country: China Institution/Affiliation country: Guangdong Provincial Peoples Hospital/CN / Southern Medical University/CN

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Full text: Available Index: LILACS (Americas) Type of study: Prognostic study / Risk factors Language: Portuguese Journal: Arq. bras. cardiol Journal subject: Cardiology Year: 2022 Type: Article / Project document Affiliation country: China Institution/Affiliation country: Guangdong Provincial Peoples Hospital/CN / Southern Medical University/CN