title: The prognostic value of serum albumin levels on admission in patients with acute ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention.
abstract: OBJECTIVE
  Hypoalbuminemia is associated with a poor prognosis in patients with end-stage renal disease, chronic ischemic heart disease, heart failure (HF), and stroke. We aimed to investigate its prognostic value in patients with acute ST-segment elevation myocardial infarction (STEMI) treated by a primary percutaneous coronary intervention (p-PCI).
  
  
  METHODS
  We retrospectively enrolled 1706 patients with STEMI treated by p-PCI. We prospectively followed up the patients for a median duration of 40 months.
  
  
  RESULTS
  On admission, hypoalbuminemia (<3.5 g/dl) was present in 519 (30.4%) patients. The incidence of final TIMI grade 3 flow (84 vs. 91.4%, P<0.001) was lower in the patients with hypoalbuminemia. In-hospital mortality (9.4 vs. 2%), HF (20.2 vs. 8.6%), and major bleeding (6 vs. 2.5%) rates were significantly higher in patients with hypoalbuminemia. However, in-hospital stroke and reinfarction rates were similar in both groups. At long-term follow-up (median duration: 42 months), all-cause mortality (23.3 vs. 8.4%, P<0.001), reinfarction (11.6 vs. 7.7%, P=0.013), stroke (2.6 vs. 1.1%, P=0.031), and advanced HF (13.3 vs. 6.1%, P<0.001) rates were significantly higher in patients with hypoalbuminemia. In the Cox proportional hazard model, hypoalbuminemia was determined as an independent predictor of long-term mortality [hazard ratio 2.98, 95% confidence interval 1.35-6.58, P=0.007) and development of advanced HF (hazard ratio 2.96, 95% confidence interval 1.44-6.08, P=0.003).
  
  
  CONCLUSIONS
  Hypoalbuminemia on admission is a strong independent predictor for long-term mortality and development of advanced HF in patients with STEMI undergoing p-PCI.
authors.affiliation: Medical Park Fatih Hospital, İstanbul, Turkey.
authors.forename: Vecih
authors.initials: V
authors.lastname: Oduncu
authors.forename: Ayhan
authors.initials: A
authors.lastname: Erkol
authors.forename: Can Y
authors.initials: CY
authors.lastname: Karabay
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kurt
authors.forename: Taylan
authors.initials: T
authors.lastname: Akgün
authors.forename: Mustafa
authors.initials: M
authors.lastname: Bulut
authors.forename: Selçuk
authors.initials: S
authors.lastname: Pala
authors.forename: Cevat
authors.initials: C
authors.lastname: Kirma
mesh_terms: D002316:Cardiotonic Agents / Q000627:therapeutic use; D002784:Cholesterol / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging; D004232:Diuretics / Q000627:therapeutic use; D004363:Drug Utilization; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000097:blood / Q000453:epidemiology; D006454:Hemoglobins / Q000032:analysis; D017052:Hospital Mortality; D006801:Humans; D034141:Hypoalbuminemia / Q000453:epidemiology*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality / Q000628:therapy*; D010343:Patient Admission; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis*; D020521:Stroke / Q000453:epidemiology; D013318:Stroke Volume
chemical_list: D002316:Cardiotonic Agents; D004232:Diuretics; D006454:Hemoglobins; D012709:Serum Albumin; D002784:Cholesterol