Prognostic Significance of Serum Albumin in Patients With Acute Coronary Syndrome

• Published in: Angiology 2020-11, Vol.71 (10), p.903-908
• Main Authors: Polat, Nihat, Oylumlu, Mustafa, Işik, Mehmet Ali, Arslan, Bayram, Özbek, Mehmet, Demir, Muhammed, Kaya, Hasan, Toprak, Nizamettin
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - blood; Acute Coronary Syndrome - diagnosis; Acute Coronary Syndrome - mortality; Aged; Aged, 80 and over; Angina, Unstable - blood; Angina, Unstable - diagnosis; Angina, Unstable - mortality; Female; Humans; Hypoalbuminemia - diagnosis; Hypoalbuminemia - etiology; Hypoalbuminemia - mortality; Male; Middle Aged; Non-ST Elevated Myocardial Infarction - blood; Non-ST Elevated Myocardial Infarction - diagnosis; Non-ST Elevated Myocardial Infarction - mortality; Predictive Value of Tests; Prognosis; Retrospective Studies; ROC Curve; Serum Albumin - metabolism; Survival Rate
• ISSN: 0003-3197; 1940-1574
• DOI: 10.1177/0003319720941747

In patients with unstable angina pectoris (UAP) or non-ST elevation myocardial infarction (NSTEMI), long-term mortality remains high despite improvements in the diagnosis and treatment. In this study, we investigated whether serum albumin level is a useful predictor of long-term mortality in patients with UAP/NSTEMI. Consecutive patients (n = 403) who were hospitalized with a diagnosis of UAP/NSTEMI were included in the study. Patients were divided into 2 groups based on the presence of hypoalbuminemia and the relationship between hypoalbuminemia and mortality was analyzed. Hypoalbuminemia was detected in 34% of the patients. The median follow-up period was 35 months (up to 45 months). Long-term mortality rate was 32% in the hypoalbuminemia group and 8.6% in the group with normal serum albumin levels (P < .001). On multivariate analysis, hypoalbuminemia, decreased left ventricular ejection fraction, and increased age were found to be independent predictors of mortality (P < .05). The cutoff value of 3.10 g/dL for serum albumin predicted mortality with a sensitivity of 74% and specificity of 67% (receiver-operating characteristic area under curve: 0.753, 95% CI: 0.685-0.822). All-cause long-term mortality rates were significantly increased in patients with hypoalbuminemia. On-admission albumin level was an independent predictor of mortality in patients with UAP/NSTEMI.