Prognostic value of albumin-based indices for mortality after heart failure: a systematic review and meta-analysis.

backgroundAlbumin-based indices have been used to predict mortality after heart failure (HF). We hereby examined the utility of albumin-globin ratio, lactate-albumin ratio, blood urea nitrogen (BUN)-albumin ratio, fibrinogen-albumin ratio, and albumin-bilirubin score (ABS) in predicting mortality after HF.

methodsWe searched Embase, PubMed, Web of Science, and Scopus databases up to 2nd October 2024 for studies examining association between albumin-based indices and mortality after HF. A random-effect meta-analysis was conducted using multivariate adjusted data to calculate pooled hazard ratio (HR) with 95% confidence intervals (CI). Subgroup analysis was conducted for short-term (< 90 days) and long-term mortality (≥ 1 year) where possible.

resultsThere were seven studies on ABS, three studies each on BUN-albumin and fibrinogen-albumin ratio, and two studies each for albumin-globulin and lactate-albumin ratio. Meta-analysis showed that ABS was predictive of both short-term (HR: 2.01 95% CI: 1.01, 4.00 I

conclusionVery low quality of evidence indicates that albumin-based indices can predict mortality after HF. ABS was found to independently predict short and long-term mortality after HF. Other ratios like the albumin-globin ratio, lactate-albumin ratio, BUN-albumin ratio, and fibrinogen-albumin ratio were also found to predict mortality after HF albeit with limited data.