Clinical Implications of Serum Albumin Levels in Acute Heart Failure: Insights From DOSE-AHF and ROSE-AHF

Justin L. Grodin, Anuradha Lala, Susanna R. Stevens, Adam D. DeVore, Lauren B. Cooper, Omar F. AbouEzzeddine, Robert J. Mentz, John D. Groarke, Emer Joyce, Julie L. Rosenthal, Justin M. Vader, W. H.Wilson Tang

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Background Hypoalbuminemia is common in patients with chronic heart failure and, as a marker of disease severity, is associated with an adverse prognosis. Whether hypoalbuminemia contributes to (or is associated with) worse outcomes in acute heart failure (AHF) is unclear. We sought to determine the implications of low serum albumin in patients receiving decongestive therapies for AHF. Methods and Results Baseline serum albumin levels were measured in 456 AHF subjects randomized in the DOSE-AHF and ROSE-AHF trials. We assessed the relationship between admission albumin levels (both as a continuous variable and stratified by median albumin [≥3.5 g/dL]) and worsening renal function (WRF), worsening heart failure (WHF), and clinical decongestion by 72 hours; 7-day cardiorenal biomarkers; and post-discharge outcomes. The mean baseline albumin level was 3.5 ± 0.5 g/dL. Albumin was not associated with WRF, WHF, or clinical decongestion by 72 hours. Furthermore, there was no association between continuous albumin levels and symptom change according to visual analog scale or weight change by 72 hours. Albumin was not associated with 60-day mortality, rehospitalization, or unscheduled emergency room visits. Conclusions Baseline serum albumin levels were not associated with short-term clinical outcomes for AHF patients undergoing decongestive therapies. These data suggest that serum albumin may not be a helpful tool to guide decongestion strategies.

Original languageEnglish
Pages (from-to)884-890
Number of pages7
JournalJournal of cardiac failure
Issue number11
StatePublished - Nov 1 2016


  • Heart failure
  • diuretics
  • proteins


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