Serum albumin concentrations, effect modifiers and first incident acute myocardial infarction: A cross-sectional study of 1552 cases and 6680 controls

• The data regarding LSA concentrations as a risk factor of CAD are inconsistent.
• There has been no reports about the association of LSA with first incident AMI.
• LSA was significantly associated with first incident AMI in a dose–response manner.
• Primary hypertension and hematocrit could modify this association.

BackgroundThe data regarding low serum albumin (LSA) concentrations as a risk factor of CAD have been inconsistent and previous studies also have not considered the potential presence of multicollinearity among covariates. Additionally, there has been to date no reports about the association of LSA with first incident acute myocardial infarction (AMI) in Chinese Han ethnic population.MethodsCross-sectional study of 1552 cases and 6680 controls was performed for identifying the association of LSA with first incident AMI and its possible interactions with risk factors on first incident AMI.ResultsOn a continuous scale, 1SD (~ 5 g/l) decrease in serum albumin concentrations was significantly associated with a fully adjusted odds ratio of 1.79, 95% CI (1.54–2.04) for first incident AMI in women, 1.53, (1.41–1.69) in men, and 1.61, (1.49–1.72) in total. On a categorical scale, the association of LSA with risk of first incident AMI was stepwise significantly strengthened with the increased albumin quintiles in age categories in both sexes, without a threshold effect found. A significant interaction was found between LSA and primary hypertension, ischemic stroke and hematocrit on the risk of first incident AMI.ConclusionsLSA concentrations were significantly associated with first incident AMI in a dose–response manner in age categories in both sexes in Chinese Han ethnic population. Primary hypertension and hematocrit could modify this association. Whether the albumin transfusion for first incident AMI will improve patients' outcome deserves further studies.