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American Journal of Epidemiology Vol. 134, No. 11: 1266-1277
Copyright © 1991 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
The Relation between Serum Albumin Levels and Risk of Coronary Heart Disease in the Multiple Risk Factor Intervention Trial
1Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh Pittsburgh, PA
2MRFTT Coordinating Center, Department of Biostatistics Minneapolis, MN
3Department of Pathology, University of Vermont Medical School Burlington, VT
Reprint requests to Dr. Lewis H. Kuller, University of Pittsburgh, Graduate School of Public Health, 130 DeSoto Street, Pittsburgh, PA 15261
The relation between serum albumin levels and subsequent incidence of myocardial infarction and coronary heart disease deaths was evaluated using stored serum from the Multiple Risk Factor intervention Trial (MRFIT). There were 91 coronary heart disease deaths, 113 myocardial infarction patients, and 405 controls matched to cases within 5 years of age, treatment group, and clinic site. There was a highly significant inverse relation between serum albumin level and risk of coronary heart disease. Individuals with a baseline level of serum albumin 
4.7 g/dl had an odds ratio of 0.45 as compared with individuals with a baseline level of serum albumin <4.4 g/dl. The relation persisted after adjusting for other cardiovascular risk factors (blood pressure, smoking, and serum cholesterol). The association was stronger for coronary heart disease deaths than for surviving myocardial infarction patients, and for cigarette smokers as compared with cigarette nonsmokers. The deaths studied occurred in the time period at least 6 years after the sara had been obtained and up to 10.5 years of follow-up, and the myocardial infarctions studied occurred within the first 6.5 years of follow-up. There was no consistent relation between time and death due to coronary heart disease or myocardial infarction and albumin levels. Albumin levels are related to the acute phase reaction. Lower albumin levels may be a marker of persistent injury to arteries and progression of atherosclerosis and thrombosis. The consistent relation between albumin and coronary heart disease risk requires further evaluation.
albumins; C-reactive protein; coronary disease; smoking
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