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Published on: January 28, 2020
Serum Albumin was Associated with a Long Term Cardiovascular Mortality among Elderly Patients with Stable Coronary
Chung-Wei Cheng1, Chun-Wei Lee1,2, Shih-Chieh Chien1
1Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, MacKay Medical College.
Insights
Higher serum albumin (SA) levels in elderly patients with stable coronary artery disease (CAD) are linked to significantly lower cardiovascular (CV) mortality. This finding suggests SA may aid in predicting CV risk in this population.
Area of Science:
- Cardiology
- Biochemistry
- Geriatrics
Background:
- Serum albumin (SA) is a multifunctional protein involved in various physiological functions.
- Previous studies suggest a link between SA and atherosclerosis, potentially as an inflammatory response.
- The role of SA in cardiovascular (CV) mortality among elderly patients with stable coronary artery disease (CAD) is not well-established.
Purpose of the Study:
- To investigate the association between baseline serum albumin levels and long-term CV mortality in elderly patients with stable CAD.
- To determine if SA levels can serve as a predictor for CV mortality in this demographic.
Main Methods:
- A cohort of 321 elderly patients with stable CAD was studied, with data collected between 2003 and 2006.
- Cardiovascular mortality data were sourced from Taiwan's National Registry of Deaths.
- Cox and Fine-Gray models were employed to assess the association between SA and CV mortality, accounting for non-CV mortality as a competing event.
Main Results:
- Over a median follow-up of 97 months, 12.1% of participants died from CV causes and 23.7% from non-CV causes.
- After adjusting for covariates, patients with SA ≥ 3.75 g/dL exhibited a significantly lower frequency of CV mortality (HR: 0.20; 95% CI: 0.08-0.49; p < 0.001).
- Competing risk models also showed a reduced CV mortality risk for the SA ≥ 3.75 g/dL group (subdistribution HR: 0.27; 95% CI: 0.11-0.65; p < 0.001).
Conclusions:
- A serum albumin level of ≥ 3.75 g/dL at admission is associated with reduced long-term cardiovascular mortality in elderly patients with stable CAD.
- Serum albumin levels may be a valuable tool for risk prediction in elderly patients diagnosed with stable coronary artery disease.
Background:
Serum albumin (SA), a multifunction protein, contributes to maintaining a variety of physiological functions. Studies have linked SA to atherosclerosis with possible mechanisms including a response to inflammation. The contribution of albumin to cardiovascular (CV) mortality in elderly patients with stable coronary artery disease (CAD) remains unclear.
Methods:
We investigated 321 elderly patients with stable CAD undergoing coronary angiography between 2003 and 2006. CV mortality data were obtained from the National Registry of Deaths in Taiwan. CV mortality included deaths attributable to ischemic heart disease, congestive heart disease, and stroke. The association between baseline SA and CV mortality was assessed using a Cox model and Fine-Gray model when non-CV mortality was considered a competing event.
Results:
During a median follow-up of 97 months, 39 (12.1%) participants died from CV disease and 76 (23.7%) died from non-CV diseases. After adjusting for covariates, patients in the SA ≥ 3.75 g/dL group had a lower frequency of CV mortality compared with those in the SA < 3.75 g/dL group [hazard ratio (HR): 0.20; 95% confidence interval (CI): 0.08-0.49; p < 0.001]. Similarly, compared to the participants with non-CV mortality, the SA ≥ 3.75 g/dL group had a lower frequency of CV mortality compared with the SA < 3.75 g/dL group (subdistribution HR: 0.27; 95% CI: 0.11-0.65; p < 0.001) in adjusted competing risk models.
Conclusions:
A SA level ≥ 3.75 g/dL at admission was associated with decreased long-term CV mortality and may be useful for risk prediction in elderly patients with stable CAD.
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