{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T15:06:29Z","timestamp":1793459189617,"version":"4.5.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2009,1,28]],"date-time":"2009-01-28T00:00:00Z","timestamp":1233100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The prevalence and importance of liver function test (LFT) abnormalities in a large contemporary cohort of heart failure patients have not been systematically evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>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 &amp;lt; 0.0001) and all-cause mortality (HR 1.19 per 1 SD increase, P &amp;lt; 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Bilirubin is independently associated with morbidity and mortality. Changes in total bilirubin may offer insight into the underlying pathophysiology of chronic heart failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjhf\/hfn031","type":"journal-article","created":{"date-parts":[[2009,1,23]],"date-time":"2009-01-23T05:58:02Z","timestamp":1232690282000},"page":"170-177","source":"Crossref","is-referenced-by-count":361,"title":["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"],"prefix":"10.1093","volume":"11","author":[{"given":"Larry A.","family":"Allen","sequence":"first","affiliation":[{"name":"Division of Cardiology, University of Colorado Denver , Aurora, CO ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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