• Ting-Wei Lu, Shih-Chieh Chien, Hsin-Bang Leu, Wei-Hsian Yin, Wei-Kung Tseng, Yen-Wen Wu, Tsung-Hsien Lin, Kuan-Cheng Chang, Ji-Hung Wang, Chau-Chung Wu, Hung-I Yeh, and Jaw-Wen Chen.
• Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei City, Taiwan, ROC.
• J Chin Med Assoc. 2024 Aug 23.

BackgroundDiabetes and insulin resistance alter the physiological state of serum albumin (SA), which is a prognostic marker for stable coronary artery disease (CAD). However, whether the SA concentration is associated with long-term cardiovascular (CV) outcomes in diabetic patients with stable CAD remains unclear.MethodsIn total, 1148 patients were retrospectively identified from a nationwide multicenter cohort study on patients with stable CAD. They were categorized into four groups according to their diabetes mellitus (DM) status and SA concentration (cutoff: 4 g/dL).ResultsThe patients' mean age was 62.5 years, and 83.5% were male. Of the total patients, 405 were included in group 1 (SA ≥ 4/non-DM), 322 in group 2 (SA < 4/non-DM), 201 in group 3 (SA ≥ 4/ DM), and 220 in group 4 (SA < 4/DM). Group 4 had the oldest age and a higher prevalence of prior myocardial infarction and stroke. During the median 4.5-year follow up (interquartile range: 1.5-6.7 year), the highest and lowest survival rates in terms of all-cause and CV mortality were found in groups 1 and 4, respectively. However, no prognostic differences were noted in nonfatal stroke and myocardial infarction among the groups. The data were consistent after covariate adjustment. Using group 1 as the reference, HRs (95% CIs) for all-cause mortality in groups 2, 3, and 4 were 3.64 (1.22-10.83), 3.26 (0.95-11.33), and 5.74 (1.92-16.95), respectively, and those for CV mortality were 2.8 (0.57-13.67), 2.62 (0.40-17.28), and 6.15 (1.32-28.58), respectively.ConclusionIn diabetic patients with stable CAD, a low SA concentration (<4 g/dL) was associated with increased long-term mortality regardless of all-cause or CV reasons but not nonfatal CV events.Copyright © 2024, the Chinese Medical Association.

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