Nonlinear association between serum albumin levels and all-cause mortality in elderly patients with chronic aortic regurg-itation
Ming-Hui LI1
Qing-Rong LIU2
Zhen-Yan ZHAO1
Hai-Yan XU1
Yong-Jian WU1
the CHINA-VHD Collaborators
1.State Key Laboratory of Cardiovascular Disease,Department of Cardiology,Fuwai Hospital,National Center for Car-diovascular Disease,Chinese Academy of Medical Science and Peking Union Medical College,Beijing,China2.Depart-ment of Cardiology,Beijing Aerospace General Hospital,Beijing,China
摘要：BACKGROUND Low serum albumin levels are established predictors of adverse outcomes in various cardiovascular conditions.However,the role of serum albumin in mortality among elderly patients with chronic aortic regurgitation(AR)has not been thoroughly investigated.This study aims to assess the relationship between serum albumin levels and mortality in this specific patient population.
METHODS Our analysis included 873 elderly AR patients from the China Valvular Heart Disease study,with baseline serum albumin mea-sured at enrollment.Mortality outcomes were monitored for two years post-enrollment,employing a Cox proportional hazards model with a two-piecewise Cox proportional hazards framework to investigate the nonlinear relationship between serum albumin levels and all-cause mo-rtality.
RESULTS During the 2-year follow-up period,we observed 63 all-cause deaths.The association between serum albumin levels and all-cause mortality displayed an approximating L-shaped curve,indicating a mortality threshold at 35 g/L.For serum albumin levels below 35 g/L,each 1 g/L decrease was associated with a 25%higher risk of all-cause mortality(HR=1.25,95%CI:1.07-1.45).In contrast,no significant change in mortality risk was observed when serum albumin levels were greater than or equal to 35 g/L.Moreover,when serum albumin is classified as hypoproteinemia(serum albumin<35 g/L),the higher risks of all-cause death were observed in hypoproteinemic patients(HR=2.93,95%CI:1.50-5.74).More importantly,the association between serum albumin and death was significantly stronger in overweight/obese patients(≥24 kg/m2 vs.<24 kg/m2,Pinteraction=0.006).
CONCLUSIONS In elderly patients with AR,serum albumin levels showed an approximating L-shaped relationship with all-cause death,with thresholds of 35 g/L.Body mass index was significant effect modifiers of the association.These results suggest that serum albumin,as an inexpensive and readily available biochemical marker,may further improve the stratified risk of mortality in older AR patients.
机标关键词：associationalbuminbetweenlevelswithall-causeaorticchronic
论文发表日期：2025-04-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：10( 423-432 )