Resumo Fundamento: A disfunção hepática é uma variável postulada de prognóstico desfavorável na cardiomiopatia dilatada (CMD). Objetivo: Este estudo teve como objetivo investigar o valor prognóstico do escore albumina-bilirrubina (ALBI), um modelo relativamente novo para a avaliação da função hepática, em pacientes com CMD idiopática. Métodos: Um total de 1.025 pacientes com CMD idiopática foram incluídos retrospectivamente e divididos em três grupos com base nos escores de ALBI: grau 1 (≤ −2,60, n = 113), grau 2 (−2,60 a −1,39, n = 835) e grau 3 (> −1,39, n = 77). Foi analisada a associação do escore ALBI com eventos clínicos adversos maiores (ECAM) intra-hospitalares e mortalidade a longo prazo. Valor de p inferior a 0,05 foi considerado estatisticamente significativo. Resultados: A taxa de ECAM intra-hospitalares foi significativamente maior nos pacientes com grau 3 (2,7% versus 7,1% versus 24,7%, p < 0,001). A análise multivariada mostrou que o escore ALBI foi um preditor independente para ECAM intra-hospitalares (odds ratio ajustada = 2,80, IC 95%: 1,63 – 4,80, p < 0,001). Após seguimento mediano de 27 meses, 146 (14,2%) pacientes morreram. A curva de Kaplan-Meier indicou que a taxa cumulativa de sobrevida a longo prazo foi significativamente menor em pacientes com grau mais alto de ALBI (log-rank = 45,50, p < 0,001). O escore ALBI foi independentemente associado à mortalidade a longo prazo (hazard ratio ajustada = 2,84, IC 95%: 1,95 – 4,13, p < 0,001). Conclusão: O escore ALBI, como modelo de risco simples, pode ser considerado uma ferramenta de estratificação de risco para pacientes com CMD idiopática.

Abstract Background: Liver dysfunction is a postulated variable for poor prognosis in dilated cardiomyopathy (DCM). Objective: This study aimed to investigate the prognostic value of the albumin-bilirubin (ALBI) score, a relatively new model for evaluating liver function, in patients with idiopathic DCM. Methods: A total of 1025 patients with idiopathic DCM were retrospectively included and divided into three groups based on ALBI scores: grade 1 (≤ −2.60, n = 113), grade 2 (−2.60 to −1.39, n = 835), and grade 3 (> −1.39, n = 77). The association of ALBI score with in-hospital major adverse clinical events (MACEs) and long-term mortality was analyzed. P-value less than 0.05 was considered statistically significant. Results: The in-hospital MACEs rate was significantly higher in the grade 3 patients (2.7% versus 7.1% versus 24.7%, p < 0.001). Multivariate analysis showed that ALBI score was an independent predictor for in-hospital MACEs (adjusted odds ratio = 2.80, 95%CI: 1.63 – 4.80, p < 0.001). After a median 27-month follow-up, 146 (14.2%) patients died. The Kaplan–Meier curve indicated that the cumulative rate of long-term survival was significantly lower in patients with higher ALBI grade (log-rank = 45.50, p < 0.001). ALBI score was independently associated with long-term mortality (adjusted hazard ratio = 2.84, 95%CI: 1.95 – 4.13, p < 0.001). Conclusion: ALBI score as a simple risk model could be considered a risk-stratifying tool for patients with idiopathic DCM.

Objective. To compare cardiovascular disease (CVD) risk factors in a cohort of Mexican health workers with representative samples of US-born and Mexico-born Mexican-Americans living in the US. Materials and methods. Data were obtained from the Mexican Health Worker Cohort Study (MHWCS) in Mexico and the National Health and Nutrition Examination Survey (NHANES) IV 1999-2006 in the US. Regression analyses were used to investigate CVD risk factors. Results. In adjusted analyses, NHANES participants were more likely than MHWCS participants to have hypertension, high total cholesterol, diabetes, obesity, and abdominal obesity, and were less likely to have low HDL cholesterol and smoke. Less-educated men and women were more likely to have low HDL cholesterol, obesity, and abdominal obesity. Conclusions. In this binational study, men and women enrolled in the MHWCS appear to have fewer CVD risk factors than US-born and Mexico-born Mexican-American men and women living in the US.

Objetivo. Comparar factores de riesgo de enfermedad cardiovascular (ECV) en una cohorte de trabajadores en México, con muestras representativas de Mexicano-Estadunidenses nacidos en EU y en México. Material y métodos. Los datos se obtuvieron del Estudio de Cohorte de Trabajadores de la Salud (ECTS) en México y de la Encuesta Nacional de Salud y Nutrición (NHANES) IV 1999-2006 en EU. Se realizaron análisis de regresión para determinar los factores de riesgo de ECV. Resultados. Los análisis ajustados muestran que los participantes del NHANES fueron más propensos a presentar hipertensión, colesterol total alto, diabetes, obesidad y obesidad abdominal, que los participantes del ECTS, y menos propensos a tener colesterol HDL bajo y a fumar. Los participantes con menor educación fueron más propensos a tener niveles bajos de colesterol HDL, obesidad, y obesidad abdominal. Conclusiones. En este estudio binacional, los participantes del ECTS tienen menos factores de riesgo de ECV que los Mexicano-Estadunidenses nacidos en EU y México que viven en Estados Unidos.

Objective. To compare cardiovascular disease (CVD) risk factors in a cohort of Mexican health workers with representative samples of US-born and Mexico-born Mexican-Americans living in the US. Materials and methods. Data were obtained from the Mexican Health Worker Cohort Study (MHWCS) in Mexico and the National Health and Nutrition Examination Survey (NHANES) IV 1999-2006 in the US. Regression analyses were used to investigate CVD risk factors. Results. In adjusted analyses, NHANES participants were more likely than MHWCS participants to have hypertension, high total cholesterol, diabetes, obesity, and abdominal obesity, and were less likely to have low HDL cholesterol and smoke. Less-educated men and women were more likely to have low HDL cholesterol, obesity, and abdominal obesity. Conclusions. In this binational study, men and women enrolled in the MHWCS appear to have fewer CVD risk factors than US-born and Mexico-born Mexican-American men and women living in the US.

Objetivo. Comparar factores de riesgo de enfermedad cardiovascular (ECV) en una cohorte de trabajadores en México, con muestras representativas de Mexicano-Estadunidenses nacidos en EU y en México. Material y métodos. Los datos se obtuvieron del Estudio de Cohorte de Trabajadores de la Salud (ECTS) en México y de la Encuesta Nacional de Salud y Nutrición (NHANES) IV 1999-2006 en EU. Se realizaron análisis de regresión para determinar los factores de riesgo de ECV. Resultados. Los análisis ajustados muestran que los participantes del NHANES fueron más propensos a presentar hipertensión, colesterol total alto, diabetes, obesidad y obesidad abdominal, que los participantes del ECTS, y menos propensos a tener colesterol HDL bajo y a fumar. Los participantes con menor educación fueron más propensos a tener niveles bajos de colesterol HDL, obesidad, y obesidad abdominal. Conclusiones. En este estudio binacional, los participantes del ECTS tienen menos factores de riesgo de ECV que los Mexicano-Estadunidenses nacidos en EU y México que viven en Estados Unidos.