Serum Albumin Dynamics in Cardiovascular Disease

Serum albumin, the most abundant circulating protein, fulfils critical roles in maintaining oncotic pressure, transporting endogenous and exogenous ligands, and exerting antioxidant and anti‐inflammatory effects. In cardiovascular disease, fluctuations in serum albumin concentration reflect a balance between hepatic synthesis, capillary escape, renal loss and catabolism, all of which may be influenced by inflammation, nutrition and comorbid conditions. Hypoalbuminaemia correlates with endothelial dysfunction, heightened oxidative stress and a prothrombotic state, thereby contributing to the progression of atherosclerosis, plaque instability and adverse cardiac remodelling. Clinically, low serum albumin has emerged as a robust prognostic marker across the spectrum of coronary heart disease, heart failure and acute myocardial infarction, offering incremental risk stratification beyond traditional biomarkers. Restoration of normoalbuminaemia through nutritional support or albumin infusion remains under investigation, while dynamic changes in albumin are increasingly being integrated into predictive algorithms. Global studies underscore its relevance in diverse populations, emphasising the practicality of routine albumin measurement in guiding therapeutic decisions and improving patient outcomes.

Research from Nature Portfolio

Recent studies have explored the relationship between circulating albumin levels and coronary heart disease risk in middle‐aged and older adults. A large cross‐sectional analysis of US adults over 45 years demonstrated a significant inverse association between serum albumin concentration and coronary heart disease risk, with the strongest protective effect observed in women, individuals over 60 years and those with hypertension but without diabetes. Nonlinear modelling revealed threshold effects whereby incremental rises in albumin were linked to progressively lower odds of disease. These findings reinforce the utility of serum albumin as a modifiable biomarker in cardiovascular risk assessment.

Serum Albumin Dynamics in Cardiovascular Disease publication trend

The graph below shows the total number of articles in serum albumin dynamics in cardiovascular disease across all publications each year (not limited to Nature Index journals).

Technical terms

Serum albumin: The principal plasma protein synthesised by the liver, responsible for maintaining colloid osmotic pressure and binding various substances.

Hypoalbuminaemia: A condition defined by abnormally low serum albumin levels, often below 35 g/L, indicating malnutrition, inflammation or organ dysfunction.

Coronary heart disease (CHD): A spectrum of disorders characterised by atherosclerotic narrowing of the coronary arteries, leading to myocardial ischaemia and potential infarction.

Neutrophil percentage‐to‐albumin ratio (NPAR): A composite biomarker calculated as the neutrophil percentage divided by serum albumin concentration, reflecting both inflammatory burden and protein reserve.

Cardiometabolic diseases (CMDs): A group of interrelated conditions including hypertension, dyslipidaemia, diabetes mellitus and obesity, which collectively increase cardiovascular risk.

References

1. Critical appraisal of the role of serum albumin in cardiovascular disease. Biomarker Research (2017).
2. The negative association between serum albumin levels and coronary heart disease risk in adults over 45 years old: a cross-sectional survey. Scientific Reports (2023).
3. Multiple cardiometabolic diseases enhance the adverse effects of hypoalbuminemia on mortality among centenarians in China: a cohort study. Diabetology & Metabolic Syndrome (2023).
4. The neutrophil percentage-to-albumin ratio is associated with all-cause mortality in critically ill patients with acute myocardial infarction. BMC Cardiovascular Disorders (2022).