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Prognostic Role of Serum Albumin Levels in Elderly Patients With Non-Valvular Atrial Fibrillation

Giuseppe Armentaro1, Giulia Crudo2, Danilo Menichelli3

  • 1Geriatrics Division, "Renato Dulbecco" University Hospital of Catanzaro, Catanzaro, Italy.

European Journal of Clinical Investigation
|June 16, 2026
PubMed

Insights

Low serum albumin (SA) levels in elderly patients with atrial fibrillation (AF) predict a higher risk of major adverse cardiovascular events (MACE). This finding highlights SA as a crucial biomarker for cardiovascular risk stratification in this population.

Area of Science:

  • Cardiology
  • Geriatrics
  • Clinical Biochemistry

Background:

  • Atrial fibrillation (AF) is a prevalent arrhythmia in the elderly, increasing cardiovascular event (CVE) risk.
  • Hypoalbuminemia is a known predictor of mortality in the general population.

Purpose of the Study:

  • To assess the predictive value of serum albumin (SA) for major adverse cardiovascular events (MACE) in elderly patients with non-valvular AF.
  • To evaluate long-term MACE occurrence in relation to SA levels.

Main Methods:

  • 1057 elderly patients with non-valvular AF were analyzed.
  • Patients were stratified based on serum albumin (SA) levels: ≤3.6 g/dL (n=532) and >3.6 g/dL (n=525).
  • Major adverse cardiovascular events (MACE) and non-cardiovascular mortality were tracked over a median of 5.5 years.

Main Results:

  • Patients with SA ≤3.6 g/dL exhibited a 59% increased risk of MACE.
  • Older age (per 10 years) was associated with higher MACE risk.
  • Higher MNA scores (>24) and direct oral anticoagulant (DOAC) therapy were linked to reduced MACE risk.

Conclusions:

  • Elderly patients with non-valvular AF and SA levels ≤3.6 g/dL face elevated risks of MACE.
  • Serum albumin is a significant predictor of adverse outcomes in this patient group.
  • Lower SA levels correlate with increased non-cardiovascular mortality.
Abstract

Keywords:
MACEatrial fibrillationelderlyserum albumin

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