Yoshioka G, Natsuaki M, Goriki Y, et al. - In acute myocardial infarction (AMI) patients receiving percutaneous coronary intervention, low serum albumin (SA) at admission was found to be independently linked with higher risk for bleeding events.

• A total of 1,724 patients with AMI from the HAGAKURE-ACS registry who had primary percutaneous coronary intervention were split into 3 categories based on albumin tertiles: the low SA group (<3.8 g/100 ml), the middle SA (MSA) group (3.8 to 4.1 g/100 ml), and the normal SA (NSA) group (≥4.2 g/100 ml).

• For the primary endpoint (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries moderate/severe bleeding), a significantly higher cumulative 3-year incidence was noted in the low SA group vs in the MSA and NSA groups (30.8% and 11.9% vs 7.7%).

• At 30 days, the low SA group exhibited significantly higher cumulative incidences of the primary endpoint vs the MSA and NSA groups, both within and beyond 30 days (20.1% and 6.1% vs 3.5%; and 12.4% and 6.2% vs 4.5%; respectively).

• Post-adjustment for confounders, excess risk of bleeding events was observed in the low SA group vs NSA (hazard ratio 1.56), whereas risk of bleeding was neutral in MSA vs NSA (hazard ratio 0.94).