Prognostic Value of Serum Albumin in Elderly Cardiovascular Disease Management
- 1Department of Cardiology, The Third Clinical College, Wenzhou Medical University, Affiliated Wenzhou People’s Hospital, Hangzhou Medical College, Wenzhou, China
Abstract
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide and represents a major contributor to disability and poor health among elderly individuals, particularly those aged ≥ 65 years. Age-related physiological changes, endothelial dysfunction, inflammation, and oxidative stress play critical roles in the development and progression of CVD. Identifying reliable prognostic biomarkers is therefore essential to improve risk stratification and clinical management in this vulnerable population. Serum albumin (SA), the most abundant plasma protein, has emerged as a potential prognostic marker in elderly patients with CVD. Accumulating evidence from observational studies indicates that hypoalbuminemia is associated with increased all-cause mortality across a wide spectrum of CVDs, including coronary artery disease, heart failure, hypertension, atrial fibrillation, stroke, peripheral artery disease, and in patients undergoing various cardiovascular interventions. Importantly, low SA levels have been shown to remain an independent prognostic marker of adverse outcomes in observational studies after adjustment for confounding factors, such as malnutrition, inflammation, and comorbid conditions, although these associations may partly reflect underlying disease burden and other clinical factors. Proposed mechanisms linking hypoalbuminemia to poor outcomes include impaired antioxidant capacity, increased inflammation, endothelial dysfunction, and altered fluid balance. This review also highlights substantial heterogeneity in SA threshold values reported across studies, which may limit its standardized application in clinical practice. Although albumin supplementation has been suggested as a potential therapeutic strategy, current evidence regarding its clinical benefit remains inconclusive. SA may provide additional prognostic information in elderly patients with CVD and may support improved risk stratification across diverse clinical settings. At present, management strategies should prioritize identifying and addressing the underlying causes of hypoalbuminemia rather than routine albumin supplementation. Further well-designed studies are needed to establish standardized SA cut-off values and to clarify its role in guiding clinical decision-making in elderly cardiovascular populations.
Related
- 2026 ESC Guidelines for the management of cardiovascular disease and chronic kidney disease, in collaboration with the European Renal Association (ERA): Developed by the task force on the management of cardiovascular disease and chronic kidney disease of the European Society of Cardiology (ESC)
- Prognostic Value of the Atherogenic Index of Plasma for Severity and Cardiovascular Outcomes in Young Patients (≤35 Years) with Coronary Artery Disease: A Retrospective Study
- 2025 European Society of Cardiology guidelines for the management of cardiovascular disease and pregnancy : Statement of endorsement by the NVVC.
- Prognostic determinants in AECOPD differ by cardiovascular disease status: a two-center retrospective cohort study in China
- Prognostic value of the C-reactive protein-triglyceride-glucose index (CTI) for major adverse cardiovascular events in patients with coronary artery disease: a retrospective cohort study
BibTeX
@article{liu2026prognostic,
title = {{Prognostic Value of Serum Albumin in Elderly Cardiovascular Disease Management}},
author = {Yi Ying Liu and Hao Qing Zheng and Fan Lu Guan and Si Si Han and Shi Wei Huang and Fan Hao Ye and Wen Bing Jiang},
journal = {Cardiology research},
year = {2026},
month = oct,
doi = {10.14740/cr2286},
url = {https://europepmc.org/article/PMC/PMC13719653},
note = {CC BY},
}
RIS
TY - JOUR
TI - Prognostic Value of Serum Albumin in Elderly Cardiovascular Disease Management
AU - Yi Ying Liu
AU - Hao Qing Zheng
AU - Fan Lu Guan
AU - Si Si Han
AU - Shi Wei Huang
AU - Fan Hao Ye
AU - Wen Bing Jiang
PY - 2026
DA - 2026/10/24
JO - Cardiology research
DO - 10.14740/cr2286
UR - https://europepmc.org/article/PMC/PMC13719653
AB - Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide and represents a major contributor to disability and poor health among elderly individuals, particularly those aged ≥ 65 years. Age-related physiological changes, endothelial dysfunction, inflammation, and oxidative stress play critical roles in the development and progression of CVD. Identifying reliable prognostic biomarkers is therefore essential to improve risk stratification and clinical management in this vulnerable population. Serum albumin (SA), the most abundant plasma protein, has emerged as a potential prognostic marker in elderly patients with CVD. Accumulating evidence from observational studies indicates that hypoalbuminemia is associated with increased all-cause mortality across a wide spectrum of CVDs, including coronary artery disease, heart failure, hypertension, atrial fibrillation, stroke, peripheral artery disease, and in patients undergoing various cardiovascular interventions. Importantly, low SA levels have been shown to remain an independent prognostic marker of adverse outcomes in observational studies after adjustment for confounding factors, such as malnutrition, inflammation, and comorbid conditions, although these associations may partly reflect underlying disease burden and other clinical factors. Proposed mechanisms linking hypoalbuminemia to poor outcomes include impaired antioxidant capacity, increased inflammation, endothelial dysfunction, and altered fluid balance. This review also highlights substantial heterogeneity in SA threshold values reported across studies, which may limit its standardized application in clinical practice. Although albumin supplementation has been suggested as a potential therapeutic strategy, current evidence regarding its clinical benefit remains inconclusive. SA may provide additional prognostic information in elderly patients with CVD and may support improved risk stratification across diverse clinical settings. At present, management strategies should prioritize identifying and addressing the underlying causes of hypoalbuminemia rather than routine albumin supplementation. Further well-designed studies are needed to establish standardized SA cut-off values and to clarify its role in guiding clinical decision-making in elderly cardiovascular populations.
SN - 1923-2829
SN - 1923-2837
ER -