{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:28:59Z","timestamp":1787754539497,"version":"build-2784847793"},"reference-count":10,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>BNP is widely used for risk stratification in acute decompensated heart failure (ADHF), but its prognostic meaning may differ across clinical phenotypes, particularly cardiorenal syndrome type 1 (CRS1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis<\/jats:title>\n                    <jats:p>We hypothesized that serum albumin modifies the association between BNP and adverse in\u2010hospital course in ADHF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cohort study, adults hospitalized with ADHF were classified as CRS1 or control. The primary endpoint was adverse in\u2010hospital course, defined as in\u2010hospital death and\/or prolonged length of stay (\u2265\u200975th percentile). BNP was analyzed on the natural log scale. Multivariable logistic regression included albumin, ln(BNP), and an albumin\u2009\u00d7\u2009ln(BNP) interaction term, adjusted for age, sex, systolic blood pressure, eGFR, ejection fraction, CRS status, body mass index, and diabetes mellitus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the complete\u2010case cohort (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009292; events\u2009=\u200977), albumin significantly modified the BNP\u2010risk association (interaction\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.236 per 5\u2009g\/L; Wald\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045; likelihood\u2010ratio test\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.050). The adjusted odds ratio for a 1\u2010unit increase in ln(BNP) was 1.81 at albumin 30\u2009g\/L, 1.42 at 35\u2009g\/L, and 1.12 at 40\u2009g\/L. Discrimination improved modestly with the interaction (AUC 0.714 vs. 0.726), and the high\u2010BNP\/low\u2010albumin stratum showed the highest observed event risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Serum albumin modifies the prognostic meaning of BNP in ADHF. Integrating albumin into BNP interpretation identifies a high\u2010risk \u201ccongestion plus vulnerability\u201d phenotype and may support pragmatic triage and discharge planning in CRS\u2010enriched ADHF populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70445","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T11:37:11Z","timestamp":1786621031000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum Albumin Modifies the Prognostic Meaning of BNP in Acute Decompensated Heart Failure"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5530-486X","authenticated-orcid":false,"given":"Muneera O.","family":"AlTaweel","sequence":"first","affiliation":[{"name":"Department of Cardiac Sciences, King Abdulaziz Hospital (KAH) Ministry of National Guard\u2013Health Affairs (MNGHA) Al\u2010Ahsa Saudi Arabia"},{"name":"King Abdullah International Medical Research Center (KAIMRC) Al\u2010Ahsa Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5296-3047","authenticated-orcid":false,"given":"Elbadri I.","family":"Abdelgadir","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center (KAIMRC) Al\u2010Ahsa Saudi Arabia"},{"name":"King Abdulaziz Hospital (KAH) Ministry of National Guard\u2013Health Affairs (MNGHA) Al\u2010Ahsa Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lulwah Al","family":"Turki","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center (KAIMRC) Al\u2010Ahsa Saudi Arabia"},{"name":"King Abdulaziz Hospital (KAH) Ministry of National Guard\u2013Health Affairs (MNGHA) Al\u2010Ahsa Saudi Arabia"},{"name":"College of Applied Medical Sciences King Saud bin Abdulaziz University for Health Sciences (KSAU\u2010HS) Al\u2010Ahsa Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramy I.","family":"Abulikailik","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center (KAIMRC) Al\u2010Ahsa Saudi Arabia"},{"name":"King Abdulaziz Hospital (KAH) Ministry of National Guard\u2013Health Affairs (MNGHA) Al\u2010Ahsa Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, King Abdulaziz Hospital (KAH) Ministry of National Guard\u2013Health Affairs (MNGHA) Al\u2010Ahsa Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0446-8305","authenticated-orcid":false,"given":"Khamess O.","family":"Khamees","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center (KAIMRC) Al\u2010Ahsa Saudi Arabia"},{"name":"King Abdulaziz Hospital (KAH) Ministry of National Guard\u2013Health Affairs (MNGHA) Al\u2010Ahsa Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4023-5683","authenticated-orcid":false,"given":"Waleed","family":"Gado","sequence":"additional","affiliation":[{"name":"Department of Cardiac Sciences, King Abdulaziz Hospital (KAH) Ministry of National Guard\u2013Health Affairs (MNGHA) Al\u2010Ahsa Saudi Arabia"},{"name":"King Abdullah International Medical Research Center (KAIMRC) Al\u2010Ahsa Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"issue":"18","key":"e_1_2_8_3_1","first-page":"e895","article-title":"2022 AHA\/ACC\/HFSA Guideline for the Management of Heart Failure","volume":"145","author":"Heidenreich P. A.","year":"2022","journal-title":"Circulation"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020233"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.12.032"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.07.051"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000664"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.3363"},{"key":"e_1_2_8_9_1","first-page":"79","article-title":"Prognostic Role of Albumin Level in Heart Failure: A Systematic Review and Meta\u2010Analysis","volume":"152","author":"El Iskandarani M.","year":"2021","journal-title":"American Journal of Cardiology"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2011.02.010"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0243818"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.70445","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/clc.70445","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.70445","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:28:55Z","timestamp":1787750935000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.70445"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":10,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/clc.70445"],"URL":"https:\/\/doi.org\/10.1002\/clc.70445","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2026-03-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70445"}}