Arq. Bras. Cardiol. 2022; 118(6): 1108-1115

Albumin-Bilirubin Score to Predict Outcomes in Patients with Idiopathic Dilated Cardiomyopathy

Mei Jiang , Xue-biao Wei , Jie-leng Huang, Ze-da-zhong Su , Ying-wen Lin, Dan-qing Yu

DOI: 10.36660/abc.20210035

This Original Article is referred by the Short Editorial "Evaluation of Various Pathophysiological Pathways in the Prognosis of Heart Failure with Reduced Ejection Fraction: Seeing Beyond the Heart".

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.