Hypoalbuminemia predicts clinical outcome in patients with type B acute aortic dissection after endovascular therapy.
BACKGROUND
Few studies have reported that serum albumin (SA) levels on admission were associated with increased risk of long-term outcomes in patients with type B acute aortic dissection (AAD). The aim of this study was to investigate the effect of admission levels of SA on survival among patients with type B AAD undergoing endovascular therapy (EVT).


METHODS
A total of 131 patients with type B AAD undergoing EVT were retrospectively enrolled and followed up for 2.1years. They were divided into hypoalbuminemia and nonhypoalbuminemia groups. We analyzed the incidence of inhospital complications and long-term mortality. Kaplan-Meier curves and multivariable Cox regression analyses were used to investigate the associations between SA levels and survival.


RESULTS
Among 131 type B AAD patients, hypoalbuminemia was detected in 61 (46.6%) at admission. Compared to those without hypoalbuminemia, patients with hypoalbuminemia did not have higher inhospital complications; however, Kaplan-Meier analysis showed that they did have a significantly lower survival rate (73.8% vs 92.5%; log-rank χ(2)=9.8; P=.002). Multivariable Cox regression analysis further revealed that hypoalbuminemia was an independent predictor of long-term mortality among patients with type B AAD (hazard ratio, 4.28; 95% confidence interval, 1.36-13.47; P=.013), over 2.1years.


CONCLUSIONS
Hypoalbuminemia is common in type B AAD patients and is independently associated with increased risk of long-term death. Renal dysfunction may be the main pathophysiological mechanism underlying hypoalbuminemia in patients with type B AAD.
Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
Rui
R
Zeng
Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China.
Dongze
D
Li
Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
Lixia
L
Deng
Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China.
Yarong
Y
He
Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
Xiaolin
X
Sun
Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China.
Zhi
Z
Wan
Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China.
Hu
H
Nie
Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China. Electronic address: dxd1204@qq.com.
Xiaodong
X
Du
Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China. Electronic address: yuyuer@126.com.
Yu
Y
Cao
Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China; Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China.
Zhi
Z
Zeng
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D002681:China / Q000453:epidemiology; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D034141:Hypoalbuminemia / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome