The association of serum albumin with coronary slow flow

A number of inflammatory markers such as high-sensitivity C-reactive protein (Hs-CRP), interleukin-6 (IL-6), and fibrinogen have been shown to be associated with coronary slow flow (CSF). Our aim was to investigate the relationship between albumin, a long-acting negative acute-phase protein, and CSF.

A total of 106 patients with angiographically proven slow coronary flow and 57 control subjects with normal coronary flow were included in the study. Serum levels of Hs-CRP and albumin were measured. CSF was defined by Thrombolysis In Myocardial Infarction (TIMI) frame count (TFC) method.

Serum albumin (s-albumin) was significantly lower in the CSF group (3.79 ± 0.3 vs 4.17 ± 0.3, p < 0.001), whereas Hs-CRP level was significantly higher in the CSF group compared with the controls (1.22 ± 0.79 vs 0.76 ± 0.44, p < 0.001). S-albumin and Hs-CRP were correlated with the mean TFC in the whole study population (r= - 0.574, p < 0.001; r = 0.376, p < 0.001, respectively). Hs-CRP and low s-albumin were found to be significant predictors of CSF in the multivariate analysis. The comparison of receiver-operating characteristics curves for s-albumin and Hs-CRP demonstrated that s-albumin was the strongest predictor of CSF.

We found that s-albumin levels decreased and Hs-CRP levels increased in patients with CSF. S-albumin was also found to have superior predictive value than Hs-CRP for diagnosing CSF. S-albumin, an inexpensive and easily measurable laboratory variable, may be a useful predictor of CSF, especially when other reasons which alter its serum levels were excluded.