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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Main Authors: Alon Shechter, Shani Dahan, Arthur Shiyovich, Harel Gilutz, Ygal Plakht
Format: Article
Language:English
Published: MDPI AG 2024-11-01
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
collection DOAJ
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.
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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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AT arthurshiyovich impactofbaselinehypoalbuminemiaonlongtermsurvivalfollowingacutemyocardialinfarctionaccordingtobodymassindex
AT harelgilutz impactofbaselinehypoalbuminemiaonlongtermsurvivalfollowingacutemyocardialinfarctionaccordingtobodymassindex
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