We aimed to examine whether the efficacy of the risk of poor prognosis in patients with coronary artery disease is jointly affected by total cholesterol and baseline serum albumin in a secondary analysis of previous study. We analyzed the data of 204 patients from October 2014 to October 2017 for newly diagnosed stable CAD. The outcome was major adverse cardiac events (MACE; defined as all cause mortality, non fatal myocardial infarction, and non fatal stroke). The median duration of follow-up was 783 days. Multivariable COX model was performed to revalidate the relationship between the sALB and MACE and interaction tests were conducted to find the effects of total cholesterol on their association. A total of 28 MACE occurred among the 204 participants. The risk of MACE varied by baseline serum albumin and total cholesterol. Specifically, lower serum albumin indicated higher risk of MACE (HR 3.52, 95% CI 1.30–9.54), and a test for interaction between baseline serum albumin and total cholesterol on MACE was significant (P = 0.0005). We suggested that baseline serum albumin and total cholesterol could interactively affect the risk of poor prognosis of patients with coronary artery diseases. Our findings need to be confirmed by further randomized trials.
Background
Patients with coronary artery disease (CAD) usually show relatively poor long-term prognosis. Serum albumin level showed negative prediction of poor prognosis of CAD, while cholesterol level was also suggested poor prognosis, but most previous studies on albumin levels and prognosis in patients with CAD have not considered the effect of cholesterol levels on outcomes. Thus, we aim to investigate the prognostic impact of albumin levels under different cholesterol level groups.
Methods
We analyzed the data of 204 patients from October 2014 to October 2017 for newly diagnosed stable CAD. Albumin and cholesterol were measured at admission. The outcome was major adverse cardiac events (MACE). The median duration of follow-up was 783 days. COX models were performed to evaluate the prognostic significance of serum albumin on MACE.
Results
Higher serum albumin indicated lower risk of MACE (HR = 0.37, P = 0.0462). In participants whose total cholesterol level less than 200 mg/dL, the risk of MACE was related to lower serum albumin (HR = 0.19, P = 0.0072), but not significantly in the others (HR = 3.16, P = 0.3392).
Conclusion
In clinical practice, when using serum albumin to evaluate the prognosis of patients with cardiovascular disease, the influence of cholesterol on the evaluation results should be fully considered.
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