| Institution: | 1. Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, Rome 00161, Italy;2. Division of Cardiology, S. Maria Goretti Hospital, Latina, Italy;3. Clinica Mediterranea, Naples, Italy;1. Department of Medicine and Surgery, University of Perugia, Perugia, Italy;2. Unit of Internal Medicine, Terni University Hospital, Terni, Italy;3. Department of Medicine, Sports and Exercise Medicine Division, University of Padua, Padua, Italy;4. Unit of Cardiology, ASST-VAL Hospital of Sondrio, Sondrio, Italy;5. U.O. Medicina Interna, Asl Taranto, Presidio Ospedaliero Occidentale, Castellaneta, Italy;6. Unit of Sports Medicine, ASL Umbria 2, Terni, Italy;1. AP-HP, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Jean Verdier Hospital, Bondy, France;2. Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRA/CNAM/Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France;3. Université Denis Diderot, AP-HP Unité de Recherche Clinique St-Louis-Lariboisière, Paris, France;1. Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy;2. Department of Internal Medicine, Internal Medicine Unit, Maggiore Hospital, Bologna, Italy;3. Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy;4. Department of Internal Medicine, L. Sacco Hospital, ASST-fbf-sacco, Milan, Italy;5. Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Division of Gerontology, Sapienza University of Rome, Rome, Italy;6. Department of Medical and Surgical Sciences, University Magna-Græcia of Catanzaro, Catanzaro, Italy;7. Experimental and Clinical Department, University of Florence, Florence, Italy;8. Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy;9. Humanitas Research Hospital, Cardiovascular Department, Thrombosis and Haemorragic Diseases Center, Rozzano, Milan, Italy;10. Department of Internal Medicine 2, University Hospital of Modena, Modena, Italy;11. Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy;1. Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy;2. Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy;1. Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, University and Hospital Trust of Verona, Verona, Italy;2. Department of Epidemiology, Azienda Zero, Veneto Region, Padua, Italy;3. Azienda Zero, Veneto Region, Padua, Italy;4. Department of Pharmaceutical and Devices, Veneto Region, Venice, Italy;5. Division of Infectious Diseases, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy;1. Division of Cardiology, Department of Medicine, The University of Hong Kong Shenzhen Hospital, Shenzhen, China;2. Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province, China;3. Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China;4. Department of Ultrasound, Shenzhen Hospital, Southern Medical University, Shen Zhen, China;5. Division of Ultrasound, Department of Radiology, The University of Hong Kong Shenzhen Hospital, Shenzhen, China |
| Abstract: | Background and aimsLow 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 resultsMulticenter 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.ConclusionLow 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. |
