• Rui Zeng, Dongze Li, Lixia Deng, Yarong He, Xiaolin Sun, Zhi Wan, Hu Nie, Xiaodong Du, Yu Cao, and Zhi Zeng.
• Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
• Am J Emerg Med. 2016 Aug 1; 34 (8): 136913721369-72.

BackgroundFew studies have reported that serum albumin (SA) levels on admission were associated with increased risk of long-term outcomes in patients with type B acute aortic dissection (AAD). The aim of this study was to investigate the effect of admission levels of SA on survival among patients with type B AAD undergoing endovascular therapy (EVT).MethodsA total of 131 patients with type B AAD undergoing EVT were retrospectively enrolled and followed up for 2.1years. They were divided into hypoalbuminemia and nonhypoalbuminemia groups. We analyzed the incidence of inhospital complications and long-term mortality. Kaplan-Meier curves and multivariable Cox regression analyses were used to investigate the associations between SA levels and survival.ResultsAmong 131 type B AAD patients, hypoalbuminemia was detected in 61 (46.6%) at admission. Compared to those without hypoalbuminemia, patients with hypoalbuminemia did not have higher inhospital complications; however, Kaplan-Meier analysis showed that they did have a significantly lower survival rate (73.8% vs 92.5%; log-rank χ(2)=9.8; P=.002). Multivariable Cox regression analysis further revealed that hypoalbuminemia was an independent predictor of long-term mortality among patients with type B AAD (hazard ratio, 4.28; 95% confidence interval, 1.36-13.47; P=.013), over 2.1years.ConclusionsHypoalbuminemia is common in type B AAD patients and is independently associated with increased risk of long-term death. Renal dysfunction may be the main pathophysiological mechanism underlying hypoalbuminemia in patients with type B AAD.Copyright © 2016 Elsevier Inc. All rights reserved.

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