Low Serum Albumin Levels and In-Hospital Adverse Outcomes in Acute Coronary Syndrome

Abstract

SummaryEpidemiological studies have demonstrated an association between low serum albumin levels and coronary heart disease and mortality. Nevertheless, the impact of a low serum albumin level during acute coronary syndrome has not yet been established. The aim of the present study was to investigate whether low serum albumin levels are associated with adverse outcomes in acute coronary syndrome. We enrolled 82 consecutive patients with acute coronary syndrome from whom venous blood for serum albumin measurement was drawn immediately upon hospital admission. Thirty-five patients had a low albumin level (hypoalbuminemia) and 47 had a normal albumin level (normoalbuminemia). In-hospital adverse outcomes (death, acute heart failure, cardiogenic shock, and reinfarction) were recorded during hospitalization in the intensive coronary care unit. The results of our study showed that the incidence of in-hospital adverse outcomes was 43%, with death occurring in 8 patients (10%). In-hospital adverse outcomes occurred more frequently in patients presenting with hypoalbuminemia, whereas mortality did not differ significantly. Univariate analysis showed that hypoalbuminemia was associated with a 2.8-fold greater risk of developing adverse outcomes. This risk was greater in the subgroup of NSTEACS (5.4-fold increased risk), but not in those with STEMI. Adjustment with other covariates revealed that hypoalbuminemia did not predict independently in-hospital adverse outcomes. It interacted with other predictors, especially Killip class II-IV, which was consistently an independent predictor of in-hospital adverse outcomes. (Int Heart J 2010; 51: 221-226)

Association of Serum Prealbumin with Angiographic Severity in Patients with Acute Coronary Syndrome

“…Serum albumin is one of the classical markers determining nutritional status, and a low serum albumin level upon admission can predict in-hospital adverse outcomes in ACS [26]. Multivariate regression analysis in our study showed that albumin was independently associated with Gensini score, which is in agreement with previous studies [27–29].…”

Serum albumin level for prediction of all-cause mortality in acute coronary syndrome patients: a meta-analysis

“…ACS patients represent a heterogeneous clinical group. Hypoalbuminemia was associated with angiographic no-reflow after primary percutaneous coronary intervention in patients with STEMI [20] and in-hospital adverse outcomes in non-ST elevation ACS [21]. Moreover, analysis of serum albumin level by continuous variables in patients with first-onset acute myocardial infarction, each 1 g/dl albumin level reduction exhibited a 66 and 47% higher risk of all-cause mortality and cardiovascular death, respectively [13].…”

Critical appraisal of the role of serum albumin in cardiovascular disease

“…Hypoalbuminemia (< 3.5 g/dL) measured upon admission was associated with in-hospital adverse events, including death, acute heart failure, cardiogenic shock, and reinfarction. This association, however, is not significant by adjusting other risk factors (OR: 2.8, 95% CI: 0.7–9.5) [ 42 ] Oduncu et al retrospectively analyzed 1706 patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI), and reported that hypoalbuminemia is associated with both in-hospital mortality and long-term mortality, with a median follow-up of 40 months (23.3 vs. 8.4%, P < 0.001). In a multivariate model, hypoalbuminemia independently predicted long-term mortality (HR: 2.98, 95% CI: 1.35–6.58) [ 39 ].…”