Impact of Baseline Hypoalbuminemia on Long-Term Survival Following Acute Myocardial Infarction According to Body Mass Index
Serum albumin and body mass index (BMI, kg/m<sup>2</sup>) have been associated with outcomes following acute myocardial infarction (AMI). Aiming to assess whether the mortality risk inflicted by hypoalbuminemia (<3.5 g/dL) in this context is influenced by BMI, we conducted a retrospec...
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MDPI AG
2024-11-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/11/12/378 |
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| author | Alon Shechter Shani Dahan Arthur Shiyovich Harel Gilutz Ygal Plakht |
| author_facet | Alon Shechter Shani Dahan Arthur Shiyovich Harel Gilutz Ygal Plakht |
| author_sort | Alon Shechter |
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| description | Serum albumin and body mass index (BMI, kg/m<sup>2</sup>) have been associated with outcomes following acute myocardial infarction (AMI). Aiming to assess whether the mortality risk inflicted by hypoalbuminemia (<3.5 g/dL) in this context is influenced by BMI, we conducted a retrospective analysis of AMI survivors hospitalized during 2004–2017. Stratified by admission-time albumin level and BMI, eligible cases were evaluated for all-cause mortality up to 10 years after discharge. A total of 6283 individuals (74.1% males, mean age 64.1 ± 13.1 years, 44.3% with ST-elevation MI) were included. Of them, 22.7% had hypoalbuminemia and 1.2%, 41.0%, and 28.6% were underweight (BMI < 18.5), overweight (BMI 25–30), and obese (BMI ≥ 30), respectively. Over a median of 7.9 (IQR, 4.8–10.0) years of follow-up, 42.5% of patients died. Hypoalbuminemia was independently associated with a heightened mortality risk overall (AdjHR = 1.54, 95%CI 1.42–1.67, <i>p</i> < 0.001), accounted for by the normal weight (AdjHR = 1.73, 95%CI 1.50–1.99, <i>p</i> < 0.001), overweight (AdjHR = 1.55, 95%CI 1.35–1.79, <i>p</i> < 0.001), and class 1 obesity (BMI 30–35) (AdjHR = 1.37, 95%CI 1.12–1.68, <i>p</i> = 0.002) subgroups. Upon interaction analysis, the mortality risk imposed by hypoalbuminemia was most pronounced among individuals with normal BMI. In conclusion, hypoalbuminemia constituted a negative prognostic marker for long-term survival in AMI patients with normal or mildly elevated but not reduced or severely increased BMI. Pending further research, addressing hypoalbuminemia based on BMI range may prove beneficial. |
| format | Article |
| id | doaj-art-a7062b2c3f7e4681aafa158d74c37edf |
| institution | Kabale University |
| issn | 2308-3425 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
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| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-a7062b2c3f7e4681aafa158d74c37edf2024-12-27T14:31:46ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252024-11-01111237810.3390/jcdd11120378Impact of Baseline Hypoalbuminemia on Long-Term Survival Following Acute Myocardial Infarction According to Body Mass IndexAlon Shechter0Shani Dahan1Arthur Shiyovich2Harel Gilutz3Ygal Plakht4Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USADivision of Cardiology, Massachusetts General Hospital, Boston, MA 02114, USADepartment of Cardiology, Rabin Medical Center, Petach Tikva 4941492, IsraelGoldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, IsraelDepartment of Nursing, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, IsraelSerum albumin and body mass index (BMI, kg/m<sup>2</sup>) have been associated with outcomes following acute myocardial infarction (AMI). Aiming to assess whether the mortality risk inflicted by hypoalbuminemia (<3.5 g/dL) in this context is influenced by BMI, we conducted a retrospective analysis of AMI survivors hospitalized during 2004–2017. Stratified by admission-time albumin level and BMI, eligible cases were evaluated for all-cause mortality up to 10 years after discharge. A total of 6283 individuals (74.1% males, mean age 64.1 ± 13.1 years, 44.3% with ST-elevation MI) were included. Of them, 22.7% had hypoalbuminemia and 1.2%, 41.0%, and 28.6% were underweight (BMI < 18.5), overweight (BMI 25–30), and obese (BMI ≥ 30), respectively. Over a median of 7.9 (IQR, 4.8–10.0) years of follow-up, 42.5% of patients died. Hypoalbuminemia was independently associated with a heightened mortality risk overall (AdjHR = 1.54, 95%CI 1.42–1.67, <i>p</i> < 0.001), accounted for by the normal weight (AdjHR = 1.73, 95%CI 1.50–1.99, <i>p</i> < 0.001), overweight (AdjHR = 1.55, 95%CI 1.35–1.79, <i>p</i> < 0.001), and class 1 obesity (BMI 30–35) (AdjHR = 1.37, 95%CI 1.12–1.68, <i>p</i> = 0.002) subgroups. Upon interaction analysis, the mortality risk imposed by hypoalbuminemia was most pronounced among individuals with normal BMI. In conclusion, hypoalbuminemia constituted a negative prognostic marker for long-term survival in AMI patients with normal or mildly elevated but not reduced or severely increased BMI. Pending further research, addressing hypoalbuminemia based on BMI range may prove beneficial.https://www.mdpi.com/2308-3425/11/12/378albuminbody mass indexmyocardial infarctionsurvival |
| spellingShingle | Alon Shechter Shani Dahan Arthur Shiyovich Harel Gilutz Ygal Plakht Impact of Baseline Hypoalbuminemia on Long-Term Survival Following Acute Myocardial Infarction According to Body Mass Index Journal of Cardiovascular Development and Disease albumin body mass index myocardial infarction survival |
| title | Impact of Baseline Hypoalbuminemia on Long-Term Survival Following Acute Myocardial Infarction According to Body Mass Index |
| title_full | Impact of Baseline Hypoalbuminemia on Long-Term Survival Following Acute Myocardial Infarction According to Body Mass Index |
| title_fullStr | Impact of Baseline Hypoalbuminemia on Long-Term Survival Following Acute Myocardial Infarction According to Body Mass Index |
| title_full_unstemmed | Impact of Baseline Hypoalbuminemia on Long-Term Survival Following Acute Myocardial Infarction According to Body Mass Index |
| title_short | Impact of Baseline Hypoalbuminemia on Long-Term Survival Following Acute Myocardial Infarction According to Body Mass Index |
| title_sort | impact of baseline hypoalbuminemia on long term survival following acute myocardial infarction according to body mass index |
| topic | albumin body mass index myocardial infarction survival |
| url | https://www.mdpi.com/2308-3425/11/12/378 |
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