Long-Term Prognostic Value of Albumin-Bilirubin Score at Discharge in Patients with Acute Heart Failure

Liver dysfunction is associated with poorer outcomes in patients with heart failure (HF). The albumin-bilirubin (ALBI) score, which combines serum albumin and total bilirubin levels, has recently emerged as a useful tool to assess liver function and predict prognosis, yet its role in predicting long-term outcomes in patients with acute heart failure (AHF) remains unclear.A total of 492 patients with AHF who were admitted to our hospital were included in the study. The patients were divided into two groups based on their ALBI score at discharge: < -2.25 and ≥ -2.25. The primary endpoint was a composite of all-cause mortality and rehospitalization for HF.The mean age of the patients was 70 years, and 63% were male. During a median follow-up period of 189 days, patients with an ALBI score ≥ -2.25 had a significantly higher risk of the composite endpoint compared to those with an ALBI score < -2.25 (17.0% versus 7.4%, respectively; HR: 1.82, 95% CI: 1.34-2.49; P < 0.001). Multivariable Cox proportional hazards models confirmed that an ALBI score ≥ -2.25 was an independent predictor of poor outcomes, even after adjusting for factors related to HF (HR: 2.00, 95% CI: 1.29-3.13; P = 0.002).The ALBI score at discharge may be useful for risk stratification of all-cause mortality and rehospitalization for HF in patients with AHF.