Abnormal liver function tests and long-term outcomes in patients discharged after acute heart failure

Hiroshi Miyama, Yasuyuki Shiraishi, Shun Kohsaka, Ayumi Goda, Yosuke Nishihata, Yuji Nagatomo, Makoto Takei, Keiichi Fukuda, Takashi Kohno, Tsutomu Yoshikawa

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Abnormal liver function tests (LFTs) are known to be associated with impaired clinical outcomes in heart failure (HF) patients. However, this implication varies with each single LFT panel. We aim to evaluate the long-term outcomes of acute HF (AHF) patients by assessing multiple LFT panels in combination. From a prospective multicenter registry in Japan, 1158 AHF patients who were successfully discharged were analyzed (mean age, 73.9 ± 13.5 years; men, 58%). LFTs (i.e., total bilirubin, aspartate aminotransferase or alanine aminotransferase, and alkaline phosphatase) at discharge were assessed; borderline and abnormal LFTs were defined as 1 and ≥2 parameter values above the normal range, respectively. The primary endpoint was composite of all-cause death or HF readmission. At the time of discharge, 28.7% and 8.6% of patients showed borderline and abnormal LFTs, respectively. There were 196 (16.9%) deaths and 298 (25.7%) HF readmissions during a median 12.4-month follow-up period. The abnormal LFTs group had a significantly higher risk of experiencing the composite outcome (adjusted hazard ratio: 1.51, 95% confidence interval: 1.08–2.12, p = 0.017), whereas the borderline LFTs group was not associated with higher risk of adverse events when referenced to the normal LFTs group. Among AHF patients, the combined elevation of ≥2 LFT panels at discharge was associated with long-term adverse outcomes.

Original languageEnglish
Article number1730
JournalJournal of Clinical Medicine
Issue number8
Publication statusPublished - 2021 Apr 2


  • Acute heart failure
  • Liver dysfunction
  • Liver function test

ASJC Scopus subject areas

  • General Medicine


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