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Cited by 425

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Liver Function Abnormalities and Outcome in Patients with Chronic Heart Failure: Data from the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) Program

Open access
Allen, Larry A., Felker, G. Michael, Pocock, Stuart, McMurray, John J.V., Pfeffer, Marc A., Swedberg, Karl, Wang, Duolao, Yusuf, Salim, Michelson, Eric L., Granger, Christopher B., for the CHARM Investigators·2009·European Journal of Heart Failure

Abstract

Aims: The prevalence and importance of liver function test (LFT) abnormalities in a large contemporary cohort of heart failure patients have not been systematically evaluated. Methods and results: We characterized the LFTs of 2679 patients with symptomatic chronic heart failure from the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity program (CHARM). We used multivariable modelling to assess the relationships between baseline LFT values and long-term outcomes. Liver function test abnormalities were common in patients with chronic heart failure, ranging from alanine aminotransferase elevation in 3.1% of patients to low albumin in 18.3% of patients; total bilirubin was elevated in 13.0% of patients. In multivariable analysis, elevated total bilirubin was the strongest LFT predictor of adverse outcome for both the composite outcome of cardiovascular death or heart failure hospitalization (HR 1.21 per 1 SD increase, P < 0.0001) and all-cause mortality (HR 1.19 per 1 SD increase, P < 0.0001). Even after adjustment for other variables, elevated total bilirubin was one of the strongest independent predictors of poor prognosis (by global chi-square). Conclusion: Bilirubin is independently associated with morbidity and mortality. Changes in total bilirubin may offer insight into the underlying pathophysiology of chronic heart failure.

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Metadata

Authors
Allen, L. A., Felker, G. M., Pocock, S., McMurray, J. J. V., Pfeffer, M. A., Swedberg, K., Wang, D., Yusuf, S., Michelson, E. L., Granger, C. B., & for the CHARM Investigators
Venue
European Journal of Heart Failure
Published
2009-01-28
Volume
11
Issue
2
Pages
170-177
ISSN
  • 1388-9842 (ISSN-L)
  • 1879-0844
OpenAlex
W2081438731
Cited by
425
References
19
FWCI
10.48
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: Liver Function Abnormalities and Outcome in Patients with Chronic Heart Failure: Data from the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) Program. https://app.cochat.ai/papers/10.1093/eurjhf/hfn031
The paper
Allen, L. A., Felker, G. M., Pocock, S., McMurray, J. J. V., Pfeffer, M. A., Swedberg, K., Wang, D., Yusuf, S., Michelson, E. L., Granger, C. B., & for the CHARM Investigators. (2009). Liver Function Abnormalities and Outcome in Patients with Chronic Heart Failure: Data from the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) Program. European Journal of Heart Failure. https://doi.org/10.1093/eurjhf/hfn031

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.