PMID- 34344545 OWN - NLM STAT- MEDLINE DCOM- 20210927 LR - 20210927 IS - 1590-3729 (Electronic) IS - 0939-4753 (Linking) VI - 31 IP - 10 DP - 2021 Sep 22 TI - Low serum albumin levels and in-hospital outcomes in patients with ST segment elevation myocardial infarction. PG - 2904-2911 LID - S0939-4753(21)00280-5 [pii] LID - 10.1016/j.numecd.2021.06.003 [doi] AB - BACKGROUND AND AIMS: Low serum albumin (SA) is associated with an increased risk of long-term adverse events (AEs) among patients with chronic coronary syndromes. Its prognostic role in patients with ST-elevation myocardial infarction (STEMI) is less clear. To investigate the association between low SA and in-hospital AEs in STEMI patients. METHODS AND RESULTS: Multicenter retrospective cohort study of 220 STEMI patients undergoing primary percutaneous coronary intervention within 12 h from the onset of symptoms. Hypoalbuminemia was defined by serum SA <35 g/L. SA. In-hospital AEs were defined as cardiogenic shock, resuscitated cardiac arrest and death. Median SA was 38 (IQR 35.4-41.0) g/L and 37 (16.8%) patients showed hypoalbuminemia (<35 g/L) on admission. Patients with hypoalbuminemia were older, more frequently women and diabetics, prior CAD and HF. Furthermore, they showed lower hemoglobin levels and impaired renal function. At multivariable logistic regression analysis, diabetes (odds ratio [OR]:4.59, 95% confidence interval [CI] 1.71-12.28, p = 0.002) and haemoglobin (OR:0.52, 95%CI 0.37-0.72, p < 0.001) were associated with low SA. In a subgroup of 132 patients, SA inversely correlated with D-Dimer (rS -0.308, p < 0.001). Globally, twenty-eight (14.6%) AEs were recorded. Hypoalbuminemia (OR:3.43, 95%CI 1.30-9.07, p = 0.013), high-sensitive (HS)-Troponin peak above median (OR:5.41, 95%CI 1.99-14.7, p = 0.001), C-reactive protein (CRP) peak above median (OR:6.03, 95%CI 2.02-18.00, p = 0.001), and in-hospital infection (OR:3.61, 95%CI 1.21-10.80, p = 0.022) were associated with AEs. CONCLUSION: Low SA levels are associated with worse in-hospital AEs in STEMI patients, irrespective of HS-troponin and CRP plasma levels. Our findings suggest that low SA may contribute to the pro-thrombotic phenotype of these patients. CI - Copyright (c) 2021. Published by Elsevier B.V. FAU - Biccire, Flavio Giuseppe AU - Biccire FG AD - Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, Rome 00161, Italy. FAU - Pastori, Daniele AU - Pastori D AD - Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, Rome 00161, Italy. FAU - Tanzilli, Alessandra AU - Tanzilli A AD - Division of Cardiology, S. Maria Goretti Hospital, Latina, Italy. FAU - Pignatelli, Pasquale AU - Pignatelli P AD - Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, Rome 00161, Italy; Clinica Mediterranea, Naples, Italy. FAU - Viceconte, Nicola AU - Viceconte N AD - Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, Rome 00161, Italy. FAU - Barilla, Francesco AU - Barilla F AD - Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, Rome 00161, Italy. FAU - Versaci, Francesco AU - Versaci F AD - Division of Cardiology, S. Maria Goretti Hospital, Latina, Italy. FAU - Gaudio, Carlo AU - Gaudio C AD - Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, Rome 00161, Italy. FAU - Violi, Francesco AU - Violi F AD - Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, Rome 00161, Italy; Clinica Mediterranea, Naples, Italy. Electronic address: francesco.violi@uniroma1.it. FAU - Tanzilli, Gaetano AU - Tanzilli G AD - Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, Rome 00161, Italy. LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20210621 PL - Netherlands TA - Nutr Metab Cardiovasc Dis JT - Nutrition, metabolism, and cardiovascular diseases : NMCD JID - 9111474 RN - 0 (ALB protein, human) RN - 0 (Biomarkers) RN - 0 (Fibrin Fibrinogen Degradation Products) RN - 0 (fibrin fragment D) RN - ZIF514RVZR (Serum Albumin, Human) SB - IM MH - Aged MH - Aged, 80 and over MH - Biomarkers/blood MH - Female MH - Fibrin Fibrinogen Degradation Products/analysis MH - Hospitalization MH - Humans MH - Hypoalbuminemia/*blood/complications/diagnosis/mortality MH - Italy MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*adverse effects/mortality MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - ST Elevation Myocardial Infarction/complications/diagnostic imaging/mortality/*therapy MH - Serum Albumin, Human/*analysis MH - Thrombosis/blood/diagnosis/*etiology/mortality MH - Treatment Outcome OTO - NOTNLM OT - Cardiogenic shock OT - Hypoalbuminemia OT - Mortality OT - STEMI COIS- Declaration of competing interest The authors declare no conflicts of interest. EDAT- 2021/08/05 06:00 MHDA- 2021/09/28 06:00 CRDT- 2021/08/04 05:53 PHST- 2020/12/07 00:00 [received] PHST- 2021/04/22 00:00 [revised] PHST- 2021/06/07 00:00 [accepted] PHST- 2021/08/05 06:00 [pubmed] PHST- 2021/09/28 06:00 [medline] PHST- 2021/08/04 05:53 [entrez] AID - S0939-4753(21)00280-5 [pii] AID - 10.1016/j.numecd.2021.06.003 [doi] PST - ppublish SO - Nutr Metab Cardiovasc Dis. 2021 Sep 22;31(10):2904-2911. doi: 10.1016/j.numecd.2021.06.003. Epub 2021 Jun 21.