A New Model for Prognosis Assessment in Stable Coronary Artery Disease: Serum Albumin and Left Ventricular Ejection Fraction

Abstract

Abstract Objective The aim of this study is to investigate the potential of serum albumin (Alb) and left ventricular ejection fraction (LVEF) as predictors of all-cause mortality (ACD) in patients diagnosed with stable coronary artery disease (SCAD). Method Patients with SCAD were categorized into four groups based on their levels of Alb and LVEF. Kaplan-Meier curves were employed to assess and compare the ACD rates across the four groups. Receiver operating characteristic (ROC) curves were utilized to evaluate the effectiveness of predicting ACD using the combination of Alb and LVEF, as well as Alb or LVEF alone. Cox regression analysis was employed to identify the factors influencing the occurrence of ACD in patients with SCAD and to establish the correlation between Alb and LVEF. Results ACD occurred in 18 out of 203 patients with SCAD, accounting for 8.9% of the sample. The average follow-up period was 26.53 ± 14.34 months. The Kaplan-Meier analysis revealed varying risks of ACD across the four groups, with Group A having the highest risk (26.7%), followed by Group B (17.6%), Group D (0.9%), and Group C (0%). This difference was statistically significant (P < 0.001). The ROC curve analysis demonstrated that the combination of Alb and LVEF had superior predictive value for ACD (AUC = 0.888) compared to either Alb alone (AUC = 0.879) or LVEF alone (AUC = 0.651). This difference was also statistically significant (P < 0.001). Multivariate Cox regression analysis showed that Alb ≤ 4 g/dL predicted ACD events after adjusting for baseline (HR: 12.16, 95% CI: 1.57 to 94.41; P = 0.017) and treatment (HR: 19.36, 95% CI: 2.53-147.78, P = 0.004). Alb was positively correlated with LVEF (r = 0.22, P = 0.002). Conclusions Alb combined with LVEF is more effective than a single index in predicting ACD in SCAD and could be used as a new model to judge the prognosis of SCAD.