Impact of serum albumin levels on long-term all-cause, cardiovascular, and cardiac mortality in patients with first-onset acute myocardial infarction

Background: To evaluate the association of serum albumin (SA) with long-term all-cause, cardiovascular, and cardiac mortality in patients with first-onset acute myocardial infarction (AMI). Methods: The cohort study enrolled 2305 patients with first-onset AMI. The median follow-up was of 1088 days (3 years). Impacts of SA on long-time mortality after AMI were determined using multivariate Cox proportional hazard regression analysis with backward selection. Results: The patients were divided into three categories by SA tertiles (<= 3.62, 3.63-4.08, > 4.08 g/dl). High tertile group was used as reference, the adjusted HRs for all-cause death were 1.21 (P = 0.338) and 1.74 (P = 0.003) for intermediate and low tertile, respectively (p-for-trend = 0.001); The equivalent values for cardiovascular death were 1.13 (P = 0.588) and 1.64 (P = 0.022), respectively (p-for-trend = 0.009); The corresponding values for cardiac death were 1.07 (P = 0.806) and 1.59 (P = 0.048), respectively (p-for trend = 0.022). Moreover, adjusted HRs per 1-g/dl decrease in SA concentrations were 1.66 (P = 0.001) for all cause death, 1.47 (P = 0.024) for cardiovascular death, and 1.61 (P = 0.012) for cardiac death. Conclusions: Low SA level (<= 3.62 g/dI) on admission was an independent predictor of long-term all-cause, cardiovascular, and cardiac mortality in patients with first-onset AMI. There was a dose-response relationship between decreased SA concentrations and increased long-term all-cause, cardiovascular, and cardiac mortality.