Usefulness of Serum Albumin Concentration to Predict High Coronary SYNTAX Score and In-Hospital Mortality in Patients With Acute Coronary Syndrome

Abstract

High SYNTAX score is a predictor of adverse cardiovascular events, including mortality, in acute coronary syndromes (ACSs). Decreased serum albumin (SA) concentration is associated with an increased risk of cardiovascular events. We aimed to investigate whether SA levels at admission are associated with high SYNTAX score and in-hospital mortality in patients with ACS. The study included 1303 patients with ACS who underwent coronary angiography (CA). The patients were divided into 2 groups as high SYNTAX score (!33) and lower SYNTAX score ( 32). Baseline SA levels were significantly lower in patients with high SYNTAX score than with lower SYNTAX score (3.46 + 0.42 mg/dL vs 3.97+0.37 mg/dL, respectively; P < .001). On multivariate logistic regression, SA (<3.65 mg/dL) was an independent predictor of high SYNTAX score (odds ratio 4.329, 95% confidence interval 2.028-8.264; P < .001) together with admission glucose, estimated glomerular filtration rate, and left ventricular ejection fraction. In Cox regression analyses, systolic blood pressure, high SYNTAX score, and SA (<3.65 mg/dL) were found as independent predictors of in-hospital all-cause mortality. In conclusion, SA concentration on admission is inversely associated with high SYNTAX score and in-hospital mortality in ACS.

Usefulness of The C‐Reactive Protein/Albumin Ratio for Predicting No‐Reflow in ST‐elevation myocardial infarction treated with primary percutaneous coronary intervention

“…It has been established that a decrease in SA level is related to poor in-hospital survival as well as in-stent restenosis, coronary artery disease severity and contrast-induced acute kidney injury. [25][26][27] It has been noted that a decrease in albumin levels and an increase in CRP can be linked to an STEMI patient's NR. [9][10][11] The pathophysiological role is, however, not completely comprehended.…”

Relationship between C‐reactive protein/albumin ratio and coronary artery disease severity in patients with stable angina pectoris

“…Decreased albumin level may be associated with increased risk of morbidity and mortality in a range of cardiovascular diseases . Kurtul and colleagues demonstrated that decreased albumin level is an independent predictor of high SS and in‐hospital mortality in patients with acute coronary syndrome . Decreased albumin level, which is associated with the chronic nature of the disease, represents the inflammatory status .…”

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

“…However, in the logistic regression analysis, the odds ratios of high Gensini score (OR=1.17, 95% CI: 0.75–1.82, p=0.50) and triple-vessel disease (OR=0.99, 95% CI: 0.63–1.56, p=0.97) in patients in the lowest tertile of albumin were not significant compared with the highest tertile after adjusting for other factors (data not shown). This discordance may due to the discrepancies of study population and the methods of evaluating coronary stenosis, as in 1 study SYNTAX score was used for assessing coronary stenosis [28]. …”