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Thromb Haemost 2004; 91(03): 610-618
DOI: 10.1160/TH03-08-0504
Cell Signaling and Vessel Remodeling
Schattauer GmbH

Serum albumin predicts cardiac adverse events in patients with advanced atherosclerosis – interrelation with traditional cardiovascular risk factors

Martin Schillinger
1   Department of Angiology, Vienna General Hospital, Medical School, Vienna, Austria
,
Markus Exner
2   Department of Laboratory Medicine, Vienna General Hospital, Medical School, Vienna, Austria
,
Wolfgang Mlekusch
1   Department of Angiology, Vienna General Hospital, Medical School, Vienna, Austria
,
Jasmin Amighi
1   Department of Angiology, Vienna General Hospital, Medical School, Vienna, Austria
,
Schila Sabeti
1   Department of Angiology, Vienna General Hospital, Medical School, Vienna, Austria
,
Oliver Schlager
1   Department of Angiology, Vienna General Hospital, Medical School, Vienna, Austria
,
Oswald Wagner
2   Department of Laboratory Medicine, Vienna General Hospital, Medical School, Vienna, Austria
,
Erich Minar
1   Department of Angiology, Vienna General Hospital, Medical School, Vienna, Austria
› Author Affiliations
Further Information

Publication History

Received 05 August 2003

Accepted after revision 11 February 2003

Publication Date:
05 December 2017 (online)

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Summary

Low serum albumin is a powerful predictor of cardiovascular adverse events in healthy subjects and patients with subclinical atherosclerosis. We investigated the association between serum albumin, traditional cardiovascular risk factors, markers of inflammation and cardiovascular outcome in 515 patients with advanced atherosclerosis and severe peripheral artery disease. Cardiovascular risk profile, serum albumin, serum amyloid A (SAA) and fibrinogen were obtained at baseline, and patients were followed for median 21 months (interquartile range 12 to 25) for the occurrence of major adverse cardiac events (MACE: myocardial infarction, percutaneous coronary interventions, coronary artery bypass graft, and death). We observed 135 MACE in 109 patients (21%). Cumulative event-free survival rates at 6, 12, and 24 months were 95%, 91%, and 80%, respectively. Low albumin predicted MACE independently of SAA and fibrinogen. Adjusted hazard ratios for the occurrence of MACE, any death, and the composite of death and MI according to increasing quartiles of albumin were 2.40, 1.14 and 1.09 (p<0.001), 2.94, 1.34 and 1.11 (p=0.003) and 3.63, 1.86 and 1.29 (p<0.001), respectively, as compared to the highest quartile. Considering albumin in conjunction with traditional cardiovascular risk factors (smoking, hyperlipidemia, hypertension and diabetes), we found that low albumin predicted MACE only in patients with a low risk profile (less than 3 risk factors) (p<0.001), whereas low albumin was not associated with MACE in patients with three or more risk factors (p=0.66). We conclude that low serum albumin is associated with cardiovascular outcome of patients with advanced atherosclerosis adding to the prognostic information of other inflammatory markers, and may be particularly useful for risk prediction in patients with few traditional risk factors.

Keywords

Arteriosclerosis - complications - inflammation - albumin
 

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