Prognostic impact of follow‐up serum albumin after acute myocardial infarction

Yoshioka, Goro; Tanaka, Atsushi; Nishihira, Kensaku; Natsuaki, Masahiro; Kawaguchi, Atsushı; Watanabe, Nozomi; Shibata, Yoshisato; Node, Koichi

doi:10.1002/ehf2.13640

Cited by 14 publications

(11 citation statements)

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“…Individual blood parameters considered for the risk assessment in the present study are useful markers for predicting the prognosis in patients with AMI [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. In particular, the presence of anemia or renal dysfunction is a powerful predictor of poor outcomes in post-AMI patients [ 7 , 8 , 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…The laboratory variables significantly associated with post-discharge death selected by the univariate analysis were categorized based on the cutoff values reported previously [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ] and then applied for the multivariable analysis to develop the risk-score model. Those variables were further selected using a multivariable logistic regression model using the backward factor elimination method.…”

Section: Methodsmentioning

confidence: 99%

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Development of a Laboratory Risk-Score Model to Predict One-Year Mortality in Acute Myocardial Infarction Survivors

Goriki

Tanaka

Yoshioka

et al. 2022

JCM

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The high post-discharge mortality rate of acute myocardial infarction (AMI) survivors is concerning, indicating a need for reliable, easy-to-use risk prediction tools. We aimed to examine if a combined pre-procedural blood testing risk model predicts one-year mortality in AMI survivors. Overall, 1355 consecutive AMI patients who received primary coronary revascularization were divided into derivation (n = 949) and validation (n = 406) cohorts. A risk-score model of parameters from pre-procedural routine blood testing on admission was generated. In the derivation cohort, multivariable analysis demonstrated that hemoglobin < 11 g/dL (odds ratio (OR) 4.01), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (OR 3.75), albumin < 3.8 mg/dL (OR 3.37), and high-sensitivity troponin I > 2560 ng/L (OR 3.78) were significantly associated with one-year mortality after discharge. An increased risk score, assigned from 0 to 4 points according to the counts of selected variables, was significantly associated with higher one-year mortality in both cohorts (p < 0.001). Receiver-operating characteristics curve analyses of risk models demonstrated adequate discrimination between patients with and without one-year death (area under the curve (95% confidence interval) 0.850 (0.756–0.912) in the derivation cohort; 0.820 (0.664–0.913) in the validation cohort). Our laboratory risk-score model can be useful for predicting one-year mortality in AMI survivors.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Development of a Laboratory Risk-Score Model to Predict One-Year Mortality in Acute Myocardial Infarction Survivors

Goriki

Tanaka

Yoshioka

et al. 2022

JCM

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“…Low serum albumin in the remote phase after acute myocardial infarction was a valuable predictor of long-term adverse outcomes. 12 Furthermore, in a cohort of 1726 patients with systolic HF, hypoalbuminemia was independently associated with an increased risk of death. 13 Similarly, Liu et al also identified hypoalbuminemia as the independent predictor for death in patients with HF with preserved ejection fraction.…”

Section: Introductionmentioning

confidence: 99%

“…In a large Viennese patient cohort, Grimm et al 11 found a significant inverse association between serum albumin levels and mortality. Low serum albumin in the remote phase after acute myocardial infarction was a valuable predictor of long‐term adverse outcomes 12 . Furthermore, in a cohort of 1726 patients with systolic HF, hypoalbuminemia was independently associated with an increased risk of death 13 .…”

Section: Introductionmentioning

confidence: 99%

Association between serum albumin to serum creatinine ratio and mortality risk in patients with heart failure

Li,

Xie,

Zeng

et al. 2023

Clinical Translational Sci

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The aim of this study was to investigate the association between serum albumin to serum creatinine ratio (sACR) and the prognosis of HF. In this single‐center prospective cohort study, a total of 2625 HF patients were enrolled between March 2012 and June 2017. All patients were divided into three groups according to the tertiles of sACR. Of 2625 patients, the mean age was 57.0±14.3. During a median follow‐up time of 23 months, 666 end point events occurred. Prognosis analysis indicated that the lowest sACR ratio was significantly associated with higher mortality risk of HF (HR= 1.920, 95% CI=1.585‐2.326; P< 0.001) when compared with the highest tertile. After adjusting for covariates including age, gender, diabetes, SBP, DBP, heart rate, total cholesterol, triglycerides, HDL‐C, LDL‐C, white blood cell count, hemoglobin, glycosylated hemoglobin and β‐blocer use, the HRs for mortality risk of HF was 1.513 (95% CI= 1.070‐2.139; P = 0.019). Subgroup analysis indicated that the mortality risk of HF statistically significantly reduced with the rise in sACR ratio in patients with no β‐blocker use, patients with serum creatine <97 μmol/L. However, stratification by age, sex, history of hypertension, diabetes and smoking, level of glycosylated hemoglobin and albumin have no obvious effect on the association between sACR ratio and the prognosis of HF. Additionally, patients with lower sACR displayed reduced left ventricular ejection fraction and increased left ventricular end‐diastolic diameter. The discriminant power of sACR alone and in combination with age, gender, SBP, heart rate and glycosylated hemoglobin were excellent with C statistic of 0.655 and 0.889, respectively. Lower sACR ratio was an independent risk factor for mortality risk of HF.

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“…Cardiovascular disease (CVD) mainly includes coronary heart disease (CHD), stroke, heart failure (HF), and also covers other cardiovascular conditions ( 1 ). Accumulating evidence has shown that low albumin level is a well-established risk factor for its subtypes ( 2 ), such as stable CHD ( 3 ), acute coronary syndrome ( 4 – 9 ), acute and chronic HF ( 10 – 18 ), and ischemic stroke ( 19 – 21 ). In patients with acute coronary syndrome, as compared with albumin ≥3.5 g/dl, those with albumin <3.5 g/dl were associated with a 2.8-fold greater risk of adverse outcomes (death, acute heart failure, cardiogenic shock, and reinfarction) ( 4 ); A 3-year follow-up study of patients with first-onset acute myocardial infarction found per 1 g/dl decrease was associated with an unadjusted hazard ratio (95% CI) of 4.11 (3.17–5.33) ( 6 ); Hypoalbuminemia (≤3.4 g/dl) predicted 1-year mortality in acute decompensated heart failure [HR (95% CI), 2.05 (1.10–3.81)], and also predicted one and a half year- mortality in patients with chronic heart failure [HR (95% CI), 5.74 (4.08–8.07)], when compared with non-hypoalbuminemia ( 11 , 14 ).…”

Section: Introductionmentioning

confidence: 99%

J-shaped association between serum albumin levels and long-term mortality of cardiovascular disease: Experience in National Health and Nutrition Examination Survey (2011–2014)

Zhang²,

He³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundCardiovascular disease (CVD) is a constellation of heart, brain, and peripheral vascular diseases with common soil hypothesis of etiology, and its subtypes have been well-established in terms of the albumin-mortality association. However, the association between albumin and the mortality of CVD as a whole remains poorly understood, especially the non-linear association. We aimed to investigate the association of albumin levels with long-term mortality of CVD as a whole.Materials and methodsThis study included all CVD patients who participated in the National Health and Nutrition Examination Survey (NHANES 2011–2014). CVD was defined as coronary heart disease, stroke, heart failure, or any combination of these two or three diseases. Serum albumin was tertile partitioned: tertile 1, <4.1; tertile 2, 4.1–4.3; and tertile 3, >4.3 g/dl. COX proportional hazards model was used to assess the association between the serum albumin levels and CVD mortality. Restricted cubic spline (RCS) curves were used to explore the non-linear relationship.ResultsA total of 1,070 patients with CVD were included in the analysis, of which 156 deaths occurred during a median 34 months of follow-up. On a continuous scale, per 1 g/dl albumin decrease was associated with an adjusted HR (95% CI) of 3.85 (2.38–6.25). On a categorical scale, as compared with tertile 3, the multivariable adjusted hazard ratio (95% CI) was 1.42 (0.74–2.71) for the tertile 2, and 2.24 (1.20–4.16) for the tertile 1, respectively, with respect to mortality. RCS curve analysis revealed a J-shaped association between albumin and CVD mortality.ConclusionA J-shaped association between low serum albumin levels and increased long-term mortality of CVD has been revealed. This J-shaped association’s implications for CVD prevention and treatment are deserving of being further studied.

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Prognostic impact of follow‐up serum albumin after acute myocardial infarction

Cited by 14 publications

References 40 publications

Development of a Laboratory Risk-Score Model to Predict One-Year Mortality in Acute Myocardial Infarction Survivors

Development of a Laboratory Risk-Score Model to Predict One-Year Mortality in Acute Myocardial Infarction Survivors

Association between serum albumin to serum creatinine ratio and mortality risk in patients with heart failure

J-shaped association between serum albumin levels and long-term mortality of cardiovascular disease: Experience in National Health and Nutrition Examination Survey (2011–2014)

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