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Association between albumin changes and prognosis in older patients with acute myocardial infarction
Zhi-Cheng Yang1, Lei Zhang2, Ying-Bin Xi3
1School of Nursing and Rehabilitation, Shandong University; Department of Geriatric Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China.
Insights
Albumin changes in older patients with acute myocardial infarction (AMI) show an S-shaped association with mortality. Lower or higher albumin levels correlate with better outcomes, while intermediate levels increase mortality risk. Albumin changes also link to reduced gastrointestinal bleeding and heart failure.
Area of Science:
- Cardiology
- Biochemistry
- Geriatrics
Background:
- Acute myocardial infarction (AMI) is a leading global cause of death.
- Early prognosis assessment in older AMI patients is crucial for effective treatment.
- This study investigates the prognostic value of albumin changes in elderly AMI patients.
Purpose of the Study:
- To explore the association between albumin level changes and prognosis in older patients diagnosed with AMI.
- To identify specific albumin change thresholds associated with mortality and adverse outcomes.
- To provide insights for improved clinical management strategies.
Main Methods:
- Utilized multivariable-adjusted Cox regression analysis and curve fitting.
- Included 288 older patients with AMI.
- Assessed outcomes including all-cause death, cardiac death, gastrointestinal hemorrhage, and acute heart failure.
Main Results:
- A significant S-shaped association was observed between albumin changes and mortality in older AMI patients.
- Inflection points for all-cause mortality were approximately -3.27 g/L and 0.92 g/L.
- Albumin changes were negatively associated with gastrointestinal hemorrhage (OR: 0.87) and acute heart failure (OR: 0.86).
Conclusions:
- Albumin level changes exhibit a complex, S-shaped relationship with mortality in older AMI patients.
- Specific albumin change thresholds indicate increased mortality risk.
- Albumin dynamics are linked to reduced risks of gastrointestinal bleeding and acute heart failure, offering clinical utility.
Background And Aims:
Acute myocardial infarction (AMI) is the leading cause of death in the world. Therefore, early identification of the prognosis of older patients with AMI are particularly urgent, and better to improve treatment. This study aimed to explore the association between albumin changes and prognosis in older patients with AMI.
Methods:
Outcomes included all-cause death during hospitalization, cardiac death, gastrointestinal hemorrhage, nonfatal myocardial infarction, acute heart failure, and severe arrhythmia. Multivariable-adjusted Cox regression analysis and curve fitting were used to assess the relationship between albumin changes and prognosis in patients with AMI.
Results:
Our study included 288 older patients with AMI. A S-shaped association between the albumin changes and mortality of patients with AMI was found. For all-cause death, we found two inflection points were - 3.27 and 0.92 g/L. On the left side of -3.27 g/L, the OR was 0.41 (OR: 0.41, 95%CI: 0.32-0.64, p < 0.05). On the right side of 0.92 g/L, the OR was 0.58 (OR: 0.58, 95%CI: 0.34-0.86, p < 0.05). The OR was 2.12 between -3.27 and 0.92 g/L (OR: 2.12, 95%CI: 1.16-6.24, p < 0.05). For cardiac death, two inflection points were - 3.19 and 1.17 g/L. On the left side of -3.19 g/L, the OR was 0.45 (OR: 0.45, 95%CI: 0.28-0.79, p < 0.05). On the right side of 1.17 g/L, the OR was 0.63 (OR: 0.63, 95%CI: 0.38-0.86, p < 0.05). The OR was 4.53 between -3.19 and 1.17 g/L (OR: 4.53, 95%CI: 0.90-12.52, p > 0.05). After adjusting for all potential covariates, albumin changes were negatively associated with gastrointestinal hemorrhage (OR: 0.87; 95%CI: 0.81-0.94, p < 0.001). After adjusting for all potential covariates, albumin changes were negatively associated with acute heart failure (OR: 0.86; 95%CI: 0.75-0.99, p = 0.046).
Conclusion:
Out findings showed that a S-shaped association between the albumin changes and mortality of older AMI patients, with the inflection of roughly -3.27 g/L and 0.92/L. And changes in albumin levels are negatively correlated with gastrointestinal bleeding and acute heart failure. These findings were helpful for the clinical treatment.
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