Serum Albumin Levels on Admission Are Associated With Angiographic No-Reflow After Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction
Restricted accessResearch articleFirst published online March, 2015
Serum Albumin Levels on Admission Are Associated With Angiographic No-Reflow After Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction
Low serum albumin (SA) levels are associated with increased cardiovascular mortality. We investigated whether baseline SA levels are associated with no-reflow following primary percutaneous coronary intervention (pPCI). A total of 536 patients (aged 60 ± 13 years; 74% men) who underwent pPCI were enrolled. The patients were divided into 2 groups: no-reflow and normal-reflow. No-reflow was defined as thrombolysis in myocardial infarction ≤2 flow. Admission SA levels were significantly lower in the no-reflow group than in the normal-reflow group (3.55 ± 0.44 vs 4.01 ± 0.32 mg/dL, P < .001). Also, high-sensitivity C-reactive protein (hsCRP), creatinine, creatine kinase myocardial band isoenzyme, and troponin T were significantly higher while hemoglobin and left ventricular ejection fraction (LVEF) were significantly lower in the no-reflow group. In multivariate analysis, SA level remained an independent predictor of angiographic no-reflow (odds ratio 0.114, 95% confidence interval 0.032-0.405, P = .001) together with LVEF, hsCRP, and baseline culprit artery patency. Admission SA level was an independent predictor of no-reflow after pPCI.
GrinesCLBrowneKFMarcoJ. A comparison of immediate angioplasty with thrombolytic therapy for acute myocardial infarction. the primary angioplasty in myocardial infarction study group. N Engl J Med. 1993;328(10):673–679.
2.
StoneGWPetersonMALanskyAJDangasGMehranRLeonMB. Impact of normalized myocardial perfusion after successful angioplasty in acute myocardial infarction. J Am Coll Cardiol. 2002;39(4):591–597.
3.
MorishimaISoneTOkumuraK. Angiographic no-reflow phenomenon as a predictor of adverse long-term outcome in patients treated with percutaneous transluminal coronary angioplasty for first acute myocardial infarction. J Am Coll Cardiol. 2000;36(4):1202–1209.
TesicMBStankovicGVukcevicVOstojicMC. The use of intracoronary sodium nitroprusside to treat no-reflow after primary percutaneous coronary intervention in acute myocardial infarction. Herz. 2010;35(2):114–118.
6.
RezkallaSHKlonerRA. Coronary no-reflow phenomenon: from the experimental laboratory to the cardiac catheterization laboratory. Catheter Cardiovasc Interv. 2008;72(7):950–957.
PetersTJr. Serum albumin. Adv Protein Chem. 1985;37:161–245.
9.
GreselePDeckmynHHuybrechtsEVermylenJ. Serum albumin enhances the impairment of platelet aggregation with thromboxane synthase inhibition by increasing the formation of prostaglandin D2. Biochem Pharmacol. 1984;33(13):2083–2088.
10.
MaalejNAlbrechtRLoscalzoJFoltsJD. The potent platelet inhibitory effects of S-nitrosated albumin coating of artificial surfaces. J Am Coll Cardiol. 1999;33(5):1408–1414.
11.
MikhailidisDPGanotakisES. Plasma albumin and platelet function: relevance to atherogenesis and thrombosis. Platelets. 1996;7(3):125–137.
12.
MikhailidisDPBarradasMAMarisAJeremyJYDandonaP. Fibrinogen mediated activation of platelet aggregation and thromboxane A2 release: pathological implications in vascular disease. J Clin Pathol. 1985;38(10):1166–1171.
13.
JolesJAWillekes-KoolschijnNKoomansHA. Hypoalbuminemia causes high blood viscosity by increasing red cell lysophosphatidylcholine. Kidney Int. 1997;52(3):761–770.
14.
GillumRFMakucDM. Serum albumin, coronary heart disease, and death. Am Heart J. 1992;123(2):507–513.
15.
Klonoff-CohenHBarrett-ConnorELEdelsteinSL. Albumin levels as a predictor of mortality in the healthy elderly. J Clin Epidemiol. 1992;45(3):207–212.
16.
KullerLHEichnerJEOrchardTJGranditsGAMcCallumLTracyRP. The relation between serum albumin levels and risk of coronary heart disease in the multiple risk factor intervention trial. Am J Epidemiol. 1991;134(11):1266–1277.
17.
PhillipsAShaperAGWhincupPH. Association between serum albumin and mortality from cardiovascular disease, cancer, and other causes. Lancet. 1989;2(8677):1434–1436.
18.
OduncuVErkolAKarabayCY. The prognostic value of serum albumin levels on admission in patients with acute ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention. Coron Artery Dis. 2013;24(2):88–94.
19.
SchalkBWVisserMBremmerMAPenninxBWBouterLMDeegDJ. Change of serum albumin and risk of cardiovascular disease and all-cause mortality: longitudinal aging study Amsterdam. Am J Epidemiol. 2006;164(10):969–677.
20.
The Thrombolysis in Myocardial Infarction (TIMI) trial. Phase I findings. TIMI study group. N Engl J Med. 1985;312(14):932–936.
21.
RezkallaSHDharmashankarKCAbdalrahmanIBKlonerRA. No-reflow phenomenon following percutaneous coronary intervention for acute myocardial infarction: incidence, outcome, and effect of pharmacologic therapy. J Interv Cardiol. 2010;23(5):429–436.
22.
OduncuVErkolATanalpAC. In-hospital prognostic value of admission plasma B-type natriuretic peptide levels in patients undergoing primary angioplasty for acute ST-elevation myocardial infarction. Turk Kardiyol Dern Ars. 2011;39(7):540–548.
23.
SmithSCJrFeldmanTEHirshfeldJWJr. ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American college of cardiology/American heart association task force on practice guidelines (ACC/AHA/SCAI writing committee to update 2001 guidelines for percutaneous coronary intervention). Circulation. 2006;113(7):e166–e286.
24.
SianosGMorelMAKappeteinAP. The SYNTAX score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention. 2005;1(2):219–227.
25.
SYNTAX Score Working Group. SYNTAX Score Calculator [online algorithm]. Available at: http://www.syntaxscore.com. Accessed December 1, 2013.
26.
SchillerNBShahPMCrawfordM. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American society of echocardiography committee on standards, subcommittee on quantitation of two-dimensional echocardiograms [review]. J Am Soc Echocardiogr. 1989;2(5):358–367.
27.
ReffelmannTKlonerRA. The no-reflow phenomenon: basic science and clinical correlates. Heart. 2002;87(2):162–168.
28.
ItoH. No-reflow phenomenon and prognosis in patients with acute myocardial infarction. Nat Clin Pract Cardiovasc Med. 2006;3(9):499–506.
29.
HuczekZKochmanJFilipiakKJ. Mean platelet volume on admission predicts impaired reperfusion and long-term mortality in acute myocardial infarction treated with primary percutaneous coronary intervention. J Am Coll Cardiol. 2005;46(2):284–290.
30.
TopsakalRKayaMGKarakayaE. Relationship between no-reflow phenomenon and serotonin levels in patients with acute ST-elevation myocardial infarction who underwent primary percutaneous intervention. Anadolu Kardiyol Derg. 2010;10(3):253–259.
31.
LibbyP. Molecular bases of the acute coronary syndromes. Circulation. 1995;91(11):2844–2850.
32.
DaneshJCollinsRApplebyPPetoR.Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: meta-analyses of prospective studies. JAMA. 1998;279(18):1477–1482.
33.
GabayCKushnerI.Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340(6):448–454. Erratum in: N Engl J Med. 1999;340(17):1376.
34.
GanotakisESVrentzosGEGaziIF. Fibrinogen, lipoprotein (a), albumin and bilirubin (F-L-A-B) levels and cardiovascular risk calculated using the Framingham equation. In Vivo. 2007;21(4):685–694.
35.
KrijgsmanBPapadakisJAGanotakisESMikhailidisDPHamiltonG. The effect of peripheral vascular disease on the serum levels of natural anti-oxidants: bilirubin and albumin. Int Angiol. 2002;21(1):44–52.
36.
CarterAMCattoAJMansfieldMWBamfordJMGrantPJ. Predictive variables for mortality after acute ischemic stroke. Stroke. 2007;38(6):1873–1880.
37.
HartopoABGhariniPPSetiantoBY. Low serum albumin levels and in-hospital adverse outcomes in acute coronary syndrome. Int Heart J. 2010;51(4):221–226.
38.
KoYGJungJHParkS. Inflammatory and vasoactive factors in the aspirate from the culprit coronary artery of patients with acute myocardial infarction. Int J Cardiol. 2006;112(1):66–71.
39.
BottoNSbranaSTrianniG. An increased platelet-leukocytes interaction at the culprit site of coronary artery occlusion in acute myocardial infarction: a pathogenic role for “no-reflow” phenomenon?Int J Cardiol. 2007;117(1):123–130.
40.
ZhangWJFreiB. Albumin selectively inhibits TNF alpha-induced expression of vascular cell adhesion molecule-1 in human aortic endothelial cells. Cardiovasc Res. 2002;55(4):820–829.
41.
DonBRKaysenG. Serum albumin: relationship to inflammation and nutrition. Semin Dial. 2004;17(6):432–437.
42.
CesariMPenninxBWNewmanAB. Inflammatory markers and onset of cardiovascular events: results from the Health ABC study. Circulation. 2003;108(19):2317–2322.
43.
KlonerRAGanoteCEJenningsRB. The “no-reflow” phenomenon after temporary coronary occlusion in the dog. J Clin Invest. 1974;54(6):1496–1508.
44.
SvilaasTVlaarPJvan der HorstIC. Thrombus aspiration during primary percutaneous coronary intervention. N Engl J Med. 2008;358(6):557–567.
