Prognostic Impact of Serum Albumin for Developing Heart Failure Remotely after Acute Myocardial Infarction

Low serum albumin (LSA) on admission for acute myocardial infarction (AMI) is related to adverse in-hospital outcomes. However, the relationship between LSA and long-term post-AMI cardiovascular outcomes is unknown. A single-center, non-randomized, retrospective study was performed to investigate the prognostic impact of LSA at admission for AMI on cardiovascular death or newly developed HF in the remote phase after AMI. Admission serum albumin tertiles (<3.8, 3.8-4.2, ≥4.2 g/dL) were used to divide 2253 consecutive AMI from February 2008 to January 2016 patients into three groups. Primary outcome was a composite of hospitalization for HF and cardiovascular death remotely after AMI. Cox proportional hazard models were used to explore the relationship between admission LSA and primary outcome. During follow-up (median: 3.2 years), primary composite outcome occurred in 305 patients (13.5%). Primary composite outcome occurred individually for hospitalization for HF in 146 patients (6.5%) and cardiovascular death in 192 patients (8.5%). The cumulative incidence of primary composite outcome was higher in the LSA group than the other groups (log-rank test, p < 0.001). Even after adjustments for relevant clinical variables, LSA (<3.8 mg/dL) was an independent predictor of remote-phase primary composite outcome, irrespective of the clinical severity and subtype of AMI. Thus, LSA on admission for AMI was an independent predictor of newly developed HF or cardiovascular death and has a useful prognostic impact even remotely after AMI.