Cheng Chung-Wei, Lee Chun-Wei, Chien Shih-Chieh, Yeh Hung-I, Chen Chun-Yen
Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, MacKay Medical College.
Department of Nursing, MacKay Junior College of Medicine, Nursing and Management, New Taipei City, Taiwan.
Acta Cardiol Sin. 2024 Jan;40(1):87-96. doi: 10.6515/ACS.202401_40(1).20230825A.
Serum albumin (SA), a multifunction protein, contributes to maintaining a variety of physiological functions. Studies have linked SA to atherosclerosis with possible mechanisms including a response to inflammation. The contribution of albumin to cardiovascular (CV) mortality in elderly patients with stable coronary artery disease (CAD) remains unclear.
We investigated 321 elderly patients with stable CAD undergoing coronary angiography between 2003 and 2006. CV mortality data were obtained from the National Registry of Deaths in Taiwan. CV mortality included deaths attributable to ischemic heart disease, congestive heart disease, and stroke. The association between baseline SA and CV mortality was assessed using a Cox model and Fine-Gray model when non-CV mortality was considered a competing event.
During a median follow-up of 97 months, 39 (12.1%) participants died from CV disease and 76 (23.7%) died from non-CV diseases. After adjusting for covariates, patients in the SA ≥ 3.75 g/dL group had a lower frequency of CV mortality compared with those in the SA < 3.75 g/dL group [hazard ratio (HR): 0.20; 95% confidence interval (CI): 0.08-0.49; p < 0.001]. Similarly, compared to the participants with non-CV mortality, the SA ≥ 3.75 g/dL group had a lower frequency of CV mortality compared with the SA < 3.75 g/dL group (subdistribution HR: 0.27; 95% CI: 0.11-0.65; p < 0.001) in adjusted competing risk models.
A SA level ≥ 3.75 g/dL at admission was associated with decreased long-term CV mortality and may be useful for risk prediction in elderly patients with stable CAD.
血清白蛋白（SA）是一种多功能蛋白质，有助于维持多种生理功能。研究已将SA与动脉粥样硬化联系起来，其可能机制包括对炎症的反应。白蛋白对老年稳定型冠状动脉疾病（CAD）患者心血管（CV）死亡率的影响仍不清楚。
我们调查了2003年至2006年间321例接受冠状动脉造影的老年稳定型CAD患者。心血管死亡率数据来自台湾国家死亡登记处。心血管死亡率包括因缺血性心脏病、充血性心脏病和中风导致的死亡。当非心血管死亡率被视为竞争事件时，使用Cox模型和Fine-Gray模型评估基线SA与心血管死亡率之间的关联。
在中位随访97个月期间，39例（12.1%）参与者死于心血管疾病，76例（23.7%）死于非心血管疾病。调整协变量后，SA≥3.75 g/dL组患者的心血管死亡率低于SA<3.75 g/dL组[风险比（HR）：0.20；95%置信区间（CI）：0.08 - 0.49；p<0.001]。同样，在调整后的竞争风险模型中，与有非心血管死亡的参与者相比，SA≥3.75 g/dL组的心血管死亡率低于SA<3.75 g/dL组（亚分布HR：0.27；95%CI：0.11 - 0.65；p<0.001）。
入院时SA水平≥3.75 g/dL与长期心血管死亡率降低相关，可能有助于老年稳定型CAD患者的风险预测。
