Prognostic Significance of Serum Albumin at Admission in Patients with Acute Coronary Syndrome

Abstract

Background: Acute Coronary Syndrome (ACS) remains a major cause of morbidity and mortality worldwide despite advances in early diagnosis and reperfusion therapy. Accurate risk stratification at hospital admission is essential for identifying patients at increased risk of adverse clinical outcomes. Serum albumin, an inexpensive and widely available laboratory biomarker, reflects both nutritional status and systemic inflammation and has emerged as a potential predictor of cardiovascular outcomes. This study evaluated the prognostic significance of serum albumin measured at admission in patients presenting with ACS.
Aim: To determine the prognostic significance of serum albumin levels at admission in patients with Acute Coronary Syndrome.
Materials and Methods: A prospective observational study was conducted in the Department of General Medicine, Katihar Medical College, Bihar. A total of 140 consecutive patients diagnosed with ACS were enrolled. Patients were categorized according to admission serum albumin levels into hypoalbuminemia and normal albumin groups. Demographic characteristics, cardiovascular risk factors, ACS subtype, electrocardiographic findings, Killip class, left ventricular ejection fraction (LVEF), inflammatory markers, and in-hospital clinical outcomes were recorded. The primary outcome was in-hospital mortality, while secondary outcomes included heart failure, arrhythmias, cardiogenic shock, prolonged hospital stay, and major adverse cardiovascular events. Statistical analysis was performed using IBM SPSS Statistics version 26.0. Continuous variables were analysed using the independent Student’s t-test, whereas categorical variables were compared using the Chi-square or Fisher’s exact test. Logistic regression was used to identify independent predictors of adverse outcomes, and a p-value <0.05 was considered statistically significant.
Results: Among 140 patients, 56 (40.0%) had hypoalbuminemia and 84 (60.0%) had normal serum albumin levels. Patients with hypoalbuminemia showed significantly higher proportions of STEMI, reduced LVEF, elevated inflammatory markers, increased in-hospital complications, and higher mortality compared with patients having normal serum albumin (p<0.001). Admission hypoalbuminemia was strongly associated with adverse clinical outcomes and poor short-term prognosis.
Conclusion: Serum albumin measured at admission is a simple, inexpensive, and reliable prognostic biomarker in patients with Acute Coronary Syndrome. Hypoalbuminemia identifies patients at increased risk of severe myocardial injury, impaired cardiac function, and adverse in-hospital outcomes, making it valuable for early risk stratification and clinical decision-making.