Association between glycated albumin and adverse outcomes in patients with heart failure

Abstract

ABSTRACTAims/IntroductionDiabetes mellitus is a traditional risk factor for heart failure (HF), and glycated albumin (GA) is a marker to assess short‐term glycemic control. Whether GA has prognostic significance in patients with HF remains unclear.Materials and MethodsA total of 717 patients with HF were enrolled in the prospective cohort study. Patients were grouped by the normal upper limit of GA (17%). Kaplan–Meier analysis and Cox proportional hazards regression were used to evaluate the association between GA and prognosis.ResultsDuring a mean follow‐up of 387 days, 232 composite endpoint events of hospitalization for HF or all‐cause death occurred. Kaplan–Meier analysis showed a higher rate of adverse events in the higher GA group (GA >17%; log‐rank test P < 0.001). GA was an independent predictor of adverse events, both as a continuous variable (per 1% change: hazard ratio [HR] 1.03, 95% confidence interval [CI] 1.00–1.06, P = 0.030) and as a categorical variable (GA >17%: HR 1.36, 95% CI 1.03–1.80, P = 0.032). Restricted cubic splines showed a linear association between GA and adverse events (P for non‐linearity = 0.231). There was no significant difference in adverse outcome risk between those with diabetes and GA ≤17% and those without diabetes, whereas the prognosis was worse in those with diabetes and GA >17% (HR 1.56, 95% CI 1.16–2.11, P = 0.004). Compared to the group with normal levels of GA and glycated hemoglobin, the group with GA >17% and glycated hemoglobin >6.5% had a higher risk of adverse events (HR 1.49, 95% CI 1.06–2.10, P = 0.022).ConclusionsGA was an independent predictor of HF prognosis. Combining GA and glycated hemoglobin might improve the predictive power of adverse outcomes in patients with HF.