Key result
Low serum albumin linked to ~59% higher MACE risk in elderly non-valvular AF patients.
Why the study?
Atrial fibrillation is common in the elderly and increases cardiovascular risk, while hypoalbuminemia predicts mortality in the general population, prompting evaluation of serum albumin's predictive value for MACE in elderly non-valvular AF patients.
Does serum albumin ≤ 3.6 g/dL predict MACE in elderly patients with non-valvular atrial fibrillation?
Observational (n=1,057)
Does serum albumin ≤ 3.6 g/dL predict MACE in elderly patients with non-valvular atrial fibrillation?
In elderly patients with non-valvular atrial fibrillation, hypoalbuminemia (≤ 3.6 g/dL) is associated with a 59% increased risk of MACE over a median 5.5-year follow-up.
Low albumin may flag higher MACE risk in elderly AF but should not yet alter practice; leaves open incremental value over standard scores.
INTRODUCTION: Atrial fibrillation (AF) is the most common arrhythmia in the elderly, and is associated with an increased risk of cardiovascular events (CVE). Hypoalbuminemia is an independent predictor of all-cause and cardiovascular mortality in general population. OBJECTIVES: The purpose of this work is to evaluate the possible predictive value of serum albumin (SA) on MACE occurrence, in a cohort of elderly patients with non-valvular AF and several comorbidities for long-term follow-up. METHODS: 1057 elderly with non-valvular AF were enrolled (75.92 ± 6.1years; 295 on VKAs and 762 on DOACs) and stratified according to median value of SA, 532 patients with SA ≤ 3.6 g/dL and 525 patients with SA > 3.6 g/dL. MACE (non-fatal ischemic stroke, non-fatal myocardial infarction and cardiovascular death), and non-cardiovascular mortality occurrence were evaluated during a median follow-up of 5.5 years (IQR 2.1-7.2). RESULTS: In the whole observational study, patients with SA ≤ 3.6 g/dL are associated with an increased risk of MACEs by 59%. In addition, 10-year ageing are associated with an increased risk of MACE; in contrast, a MNA score > 24 pt and therapy with DOACs are associated with a reduced risk of MACE. CONCLUSION: Elderly patients with non-valvular AF with SA ≤ 3.6 g/dL show a higher risk of MACE and non-cardiovascular mortality.
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Armentaro et al. (2026) conducted an observational in Non-valvular atrial fibrillation (n=1,057). Serum albumin ≤ 3.6 g/dL vs. Serum albumin > 3.6 g/dL was evaluated on MACE (non-fatal ischemic stroke, non-fatal myocardial infarction and cardiovascular death) (59% increased risk). In elderly patients with non-valvular atrial fibrillation, serum albumin ≤ 3.6 g/dL was associated with a 59% increased risk of MACE.
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