title: Serum albumin concentrations, effect modifiers and first incident acute myocardial infarction: A cross-sectional study of 1552 cases and 6680 controls.
abstract: BACKGROUND
  The data regarding low serum albumin (LSA) concentrations as a risk factor of CAD have been inconsistent and previous studies also have not considered the potential presence of multicollinearity among covariates. Additionally, there has been to date no reports about the association of LSA with first incident acute myocardial infarction (AMI) in Chinese Han ethnic population.
  
  
  METHODS
  Cross-sectional study of 1552 cases and 6680 controls was performed for identifying the association of LSA with first incident AMI and its possible interactions with risk factors on first incident AMI.
  
  
  RESULTS
  On a continuous scale, 1SD (~5 g/l) decrease in serum albumin concentrations was significantly associated with a fully adjusted odds ratio of 1.79, 95% CI (1.54-2.04) for first incident AMI in women, 1.53, (1.41-1.69) in men, and 1.61, (1.49-1.72) in total. On a categorical scale, the association of LSA with risk of first incident AMI was stepwise significantly strengthened with the increased albumin quintiles in age categories in both sexes, without a threshold effect found. A significant interaction was found between LSA and primary hypertension, ischemic stroke and hematocrit on the risk of first incident AMI.
  
  
  CONCLUSIONS
  LSA concentrations were significantly associated with first incident AMI in a dose-response manner in age categories in both sexes in Chinese Han ethnic population. Primary hypertension and hematocrit could modify this association. Whether the albumin transfusion for first incident AMI will improve patients' outcome deserves further studies.
authors.affiliation: Division of Cardiology, the First Affiliated Hospital of Soochow University, PR China. Electronic address: heyongming@suda.edu.cn.
authors.forename: Yong-Ming
authors.initials: YM
authors.lastname: He
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, PR China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Division of Cardiology, the First Affiliated Hospital of Soochow University, PR China.
authors.forename: Xiang-Jun
authors.initials: XJ
authors.lastname: Yang
authors.affiliation: Division of Cardiology, the First Affiliated Hospital of Soochow University, PR China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Division of Cardiology, the First Affiliated Hospital of Soochow University, PR China.
authors.forename: Hai-Feng
authors.initials: HF
authors.lastname: Xu
authors.affiliation: Division of Cardiology, the First Affiliated Hospital of Soochow University, PR China.
authors.forename: Yun-Xia
authors.initials: YX
authors.lastname: Qian
mesh_terms: D000208:Acute Disease; D000368:Aged; D044466:Asian People; D002681:China; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis*; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*
chemical_list: D012709:Serum Albumin
keywords: Acute myocardial infarction; Chinese Han ethnic population; Cross-sectional study; Low serum albumin concentrations; Odds ratio