The predictive value of transaminases at admission in patients hospitalized for heart failure: findings from the RO-AHFS registry.

BACKGROUND: Transaminases are commonly elevated in both the inpatient and ambulatory settings in heart failure (HF).AIMS: To determine the prevalence and degree of elevated transaminase levels at admission and to evaluate the association between transaminase levels and in-hospital morbidity and mortality.METHODS: Over a 12-month period, the Romanian Acute Heart Failure Syndromes (RO-AHFS) registry enrolled consecutive patients hospitalized for HF at 13 medical centres. A post-hoc analysis of the 489 patients (15.2%) with alanine transaminase (ALT) and aspartate transaminase (AST) (upper limits of normal 31 IU/l and 32 IU/l, respectively) measured at baseline was performed. In-hospital mortality was compared across quartiles using multivariable Cox regression models.RESULTS: The prevalences of elevated ALT and AST were 28% and 24% and the medians (interquartile range) were 22 (16-47) and 23 (16-37 IU/L). Patients with elevated transaminases more commonly had right HF, cardiogenic shock, or an ejection fraction CONCLUSIONS: In patients hospitalized for HF, there is a graded relationship between admission transaminase levels and surrogates for in-hospital morbidity, while more pronounced elevations of ALT predict in-hospital mortality independent of known prognostic indicators.

0