Liver Function Test (LFT) Predicting Mortality in Heart Failure Patients: 996

Introduction: Liver is a highly vascular organ which make it more vulnerable to circulatory disturbances especially in heart failure (HF) patients. Wide spectrum of disorders can affect the liver in cardiac patients like congestive hepatopathy, cardiac cirrhosis, and ischemic hepatitis. The aim of our study to investigate the role of liver function tests (LFTs) in HF patients and long term outcome. Methods: Retrospective chart analysis of 2048 patients whom were admitted to our hospital from 2005 to 2015 with diagnosis of acute heart failure syndrome. Logistic regression assessed the association of LFTs and 30-day all-cause mortality and HF 30-days readmission rates. Separate analyses were performed for individual LFTs. Abnormal bilirubin was defined as >1.0 mg/dL; for AST and ALT, abnormal values were defined as >35 U/L. Results: Among 2048 patients with acute heart failure syndrome, 1003 patients (48.97%) had abnormal LFTs of which 48% had abnormal total bilirubin, 32% had abnormal ALT, and 30% had abnormal AST on admission. Patients with abnormal LFTs were younger, had low body mass index BMI, and lower left ventricular ejection fraction (LVEF) compared to those with admission LFTs within the normal range. In multivariable models, higher levels of total bilirubin levels were associated with increased 30-day mortality or HF 30-days readmission rates (OR 1.17 per unit change, 95% CI 1.04, 1.32, p=0.01).Compared with normal baseline LFTs, the presence of an abnormal bilirubin was independently associated with increased 30-day all-cause mortality or HF 30-days readmission rates (OR 1.24, 95% CI 1.00, 1.54, p=0.05) and 180-day mortality (OR 1.32, 95% CI 1.08, 1.62, p=0.03). After adjustment, there was no association between AST or ALT and either outcome. Conclusion: Our study showed that abnormal LFTs is a common finding in HF patients especially in young patients with low BMI and low LVEF. Total bilirubin can predict 30 day mortality and 30-days readmission rates in HF patients. Although most HF patients have abnormal AST and ALT, the enzymes failed to predict mortality and outcome.Figure 1