DOI: https://dx.doi.org/10.18203/2349-3933.ijam20221091
Published: 2022-04-25

A study of serum albumin levels in acute coronary syndrome and its correlation with clinical outcome

Avtar Singh Dhanju, Gurpreet Singh Chhina, Praneet Manekar, Pashaura Singh Sandhu

Abstract


Background: Coronary artery disease (CAD) is major cause of death and mortality in the developed world. Coronary atherosclerotic disease involves the epicardial coronary arteries and may manifest as an acute or chronic coronary syndrome. Acute coronary syndrome (ACS) arises from atherosclerotic plaque rupture leading to coronary thrombosis and/or spasm.

Methods: The present study was conducted in department of medicine, Guru Nanak Dev hospital attached to government medical college, Amritsar from May 2021 to December 2021. This was a prospective observational study in which a total of 50 patients of ACS were enrolled. Serum albumin levels of the patients were recorded and clinical outcomes based on the albumin levels were compared between the patients.

Results: The patients with low serum albumin levels had worse outcomes. The mean serum albumin level of STEMI and NSTEMI patients in hypoalbuminemia group was 2.88±0.11 g/dl and 3.15±0.26 g/dl (p=0.047). The mean serum albumin level of patients having mortality in hypoalbuminemia group was 2.87±0.06 g/dl and those who didn’t have mortality was 3.19±0.21 g/dl (p=0.013). The mean serum albumin level of patients developing new onset heart failure in hypoalbuminemia group was 2.85±0.06 g/dl and those not developing had 3.11±0.19 g/dl (p=0.021).

Conclusions: We conclude that ACS patients presenting with hypoalbuminemia are more likely to develop worse outcomes in the form of heart failure, cardiogenic shock and mortality. ACS patients presenting with low serum albumin levels have more chances of developing STEMI.


Keywords


Acute coronary syndrome, Serum albumin, Hypoalbuminemia, Normoalbuminemia, ST elevation myocardial infarction

Full Text:

PDF

References


Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics 2014 update: a report from the American Heart Association. Circulation. 2014;129(3):e28-9.

Beltrame JF, Dreyer R, Tavella R. Epidemiology of coronary artery disease. London, UK: INTECH publisher; 2012.

Giugliano RP, Cannon CP, Braunwald E. NonST-Segment elevation acute coronary syndrome (non-st-segment elevation myocardial infarction and unstable angina). In: Harrison’s Principles of Internal Medicine. 20th ed. London, UK: INTECH publisher; 2018:1866.

Yuwen P, Chen W, Lv H, Feng C, Li Y, Zhang T, et al. Albumin and surgical site infection risk in orthopaedics: a meta-analysis. BMC Surgery. 2017; 17(1):1-9.

Zoellner H, Hofler M, Beckmann R, Hufnagl P, Vanyek E, Bielek E et al. Serum albumin is a specific inhibitor of apoptosis in human endothelial cells. J Cell Sci. 1996;109(10):2571-80.

Danesh J, Collins R, Appleby P, Peto R. Association of fibrinogen, Creactive protein, albumin, or leukocyte count with coronary heart disease: meta-analyses of prospective studies. JAMA. 1998;279(18):1477-82

Libby P. Molecular bases of the acute coronary syndromes. Circulation. 1995;91(11):2844-50.

Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. Engl J Med. 1999;340(6):448-54.

Zhang WJ, Frei B. Albumin selectively inhibits TNFα-induced expression of vascular cell adhesion molecule-1 in human aortic endothelial cells. Cardiovasc Res. 2002;55(4):820-9.

Hartopo AB, Gharini PP, Setianto BY. Low serum albumin levels and in-hospital adverse outcomes in acute coronary syndrome. Int Heart J. 2010;51(4): 221-6.

Sujino Y, Tanno J, Nakano S, Funada S, Hosoi Y, Senbonmatsu T et al. Impact of hypoalbuminemia, frailty, and body mass index on early prognosis in older patients (≥85 years) with ST-elevation myocardial infarction. J Cardiol. 2015;66(3):263-8.

Polat N, Oylumlu M, Işik MA, Arslan B, Özbek M, Demir M et al. Prognostic significance of serum albumin in patients with acute coronary syndrome. Angiology. 2020;71(10):903-8.

González-Pacheco H, Amezcua-Guerra LM, Sandoval J, Martínez-Sánchez C, Ortiz-León XA, Peña-Cabral MA et al. Prognostic implications of serum albumin levels in patients with acute coronary syndromes. Am J Cardiol. 2017;119(7):951-8.

Oduncu V, Erkol A, Karabay CY, Kurt M, Akgün T, Bulut M et al. The prognostic value of serum albumin levels on admission in patients with acute ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention. Coronary Artery Dis. 2013;24(2):88-94.

Plakht Y, Gilutz H, Shiyovich A. Decreased admission serum albumin level is an independent predictor of long-term mortality in hospital survivors of acute myocardial infarction. Soroka acute myocardial infarction II (SAMI-II) project. Int J Cardiol. 2016;219:20-4.

Zhu L, Chen M, Lin X. Serum albumin level for prediction of all-cause mortality in acute coronary syndrome patients: a meta-analysis. Biosci Rep. 2020; 40(1):881.

Xia M, Zhang C, Gu J, Chen J, Wang LC, Lu Y et al. Impact of serum albumin levels on long-term all-cause, cardiovascular, and cardiac mortality in patients with first-onset acute myocardial infarction. Clin Chimica Acta. 2018;477:89-93.

Boasi V, Sanchez FA. The prognostic values of hypoalbuminemia in patients with ST-segment elevation myocardial infarction. Eur Heart J. 2015; 36:972.