Predictive Value of Serum Albumin in Patients With Acute Coronary Syndrome

Acute coronary syndrome (ACS) refers to a group of conditions that include ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), and unstable angina. It is a type of coronary heart disease (CHD), which is responsible for one-third of total deaths in people older than 35. Some forms of CHD can be asymptomatic, but ACS is always symptomatic .

Long-term mortality remains high in patients presenting with ACS despite advances in diagnosis and treatment. Therefore, identification of high-risk patients in this patient group is of prime importance. To date, various risk scores and biomarkers have been used for this purpose .

Albumin is the major protein in human plasma and the most abundant protein in the extracellular compartment. Albumin has multiple important physiological functions including maintenance of plasma osmotic pressure and capillary permeability, a ligand for many endogenous and exogenous compounds and it also affects the pharmacokinetics of several drugs .

In addition, low serum albumin is associated with increased adverse clinical outcomes and prognosis in cancer, heart failure, stroke, and stable coronary artery disease (CAD). Similarly, in patients with ACS, presence of hypoalbuminemia has been associated with increased severity of coronary lesions, no-reflow, increased in-hospital, and long-term mortality as well as development of heart failure .

Until now, several studies have documented the prognostic value of SA in patients with stable coronary artery disease (CAD), ST elevation myocardial infarction, and pulmonary embolism. In this research, the authors also concluded that admission SA level was a strong and independent predictor of all-cause long-term mortality in patients with ACS. Although the research was interesting and well-conducted, we have some comments .