Islam M S, Islam M N, Kundu S K, Islam M Z, Bhuiyan A S, Haque M M, Malek M S, Paul P K, Shaha B, Thakur A K, Wahab M A, Chowdhury U W, Bhowmick K
Dr Md Saiful Islam, MD Cardiology, Thesis Part Student, Mymensingh Medical College (MMC), Mymensingh, Bangladesh.
Mymensingh Med J. 2019 Oct;28(4):744-751.
Acute myocardial infarction (AMI) patients constitute a large proportion of admissions in coronary care unit and their management and risk stratification is of immense importance. A decrease in serum albumin concentration might be associated with an increased risk in the incident of both cardiovascular diseases and worse hospital outcome. We assessed whether serum albumin levels at admission was associated with in-hospital adverse outcome in patients with first attack of acute myocardial infarction (AMI). The aim of the study was to evaluate association of serum albumin level with in-hospital outcome in patients with first attack of acute myocardial infarction. This cross-sectional analytical study was conducted in the department of cardiology in Mymensingh Medical College Hospital, Mymensingh, Bangladesh from March 2017 to February 2018. Total 374 patients of first attack of acute myocardial infarction included considering inclusion and exclusion criteria. The sample population was divided into two groups: Group I (Patients with acute myocardial infarction with serum albumin <3.5gm/dl) and. Group II (Patients with acute myocardial infarction with serum albumin ≥3.5gm/dl). Serum albumin level was measured within 24 hours of admission and the incidence of in-hospital major cardiac outcomes was observed. In this study mean±SD serum albumin level of Group I, Group II were 3.02±0.12gm/dl, 4.48±0.50gm/dl respectively. In Group I patient, 52(59.80%), 7(8.00%), 10(11.50%), developed heart failure, cardiogenic shock, arrhythmias respectively and 8(9.20%) died and in Group II patient 20(7.90%), 7(2.80%), 8(3.20%) developed heart failure, cardiogenic shock, arrhythmias respectively and 4(1.60%) died out of them and all of these outcome were statistically significant. Mean±SD duration of hospital stay of the study population according serum albumin level, in Group I, 5.76±1.83 days, in Group II, 4.40±1.22 days which was statistically significant (p<0.05). In conclusion, patient with first attack of acute myocardial infarction serum albumin level below 3.50gm/dl increased the risk of worse in-hospital outcome.
急性心肌梗死(AMI)患者占冠心病监护病房收治患者的很大比例,对他们的管理和风险分层至关重要。血清白蛋白浓度降低可能与心血管疾病发病风险增加及更差的医院结局相关。我们评估了首次发作急性心肌梗死(AMI)患者入院时的血清白蛋白水平是否与住院期间的不良结局相关。本研究的目的是评估首次发作急性心肌梗死患者血清白蛋白水平与住院结局的相关性。这项横断面分析研究于2017年3月至2018年2月在孟加拉国迈门辛市迈门辛医学院医院心脏病科进行。根据纳入和排除标准,共纳入374例首次发作急性心肌梗死的患者。样本人群分为两组:第一组(血清白蛋白<3.5g/dl的急性心肌梗死患者)和第二组(血清白蛋白≥3.5g/dl的急性心肌梗死患者)。入院后24小时内测量血清白蛋白水平,并观察住院期间主要心脏结局的发生率。本研究中,第一组、第二组的血清白蛋白水平均值±标准差分别为3.02±0.12g/dl、4.48±0.50g/dl。第一组患者中,分别有52例(59.80%)、7例(8.00%)、10例(11.50%)发生心力衰竭、心源性休克、心律失常,8例(9.20%)死亡;第二组患者中,分别有20例(7.90%)、7例(2.80%)、8例(3.20%)发生心力衰竭、心源性休克、心律失常,4例(1.60%)死亡,所有这些结局均具有统计学意义。根据血清白蛋白水平,研究人群的平均住院天数均值±标准差,第一组为5.76±1.83天,第二组为4.40±1.22天,具有统计学意义(p<0.05)。总之,首次发作急性心肌梗死患者血清白蛋白水平低于3.50g/dl会增加住院结局更差的风险。