Cholesterol affects the relationship between albumin and major adverse cardiac events in patients with coronary artery disease: a secondary analysis

Research design and population

This was a secondary scientific analysis of a single center retrospective cohort study where the data set was collected by Sho et al. and is now available on Dryad (via: https://doi.org/10.5061/dryad.fn6730j)15. As previously described, the cohort included inpatients newly diagnosed with stable coronary artery disease and treated with PCI at Shinonoi General Hospital from October 2014 to October 2017 at Shinonoi General Hospital. Patients with a previous myocardial infarction or a malignant tumor were excluded. All participants were enrolled after approval from the Shinonoi General Hospital ethics committee and written informed consent. The research was in accordance with the principles set out in the Declaration of Helsinki. The outcome was major adverse cardiac events (MACE; defined as all-cause mortality, non-fatal myocardial infarction, and non-fatal stroke). Events were validated by chart review and the median duration of follow-up was 783 days15. In our analysis, we included all cases to revalidate the relationship between sALB and MACE by adjusting for more covariates than previous research.15and above all, we tried to find the effects of CTs on their association by interaction tests.

statistical analyzes

The baseline characteristics of the participants were analyzed and divided into two groups based on the baseline median level of sALB. Continuous variables with normal distribution were presented as mean ± SD (comparison between groups by t-test), continuous variables with abnormal distribution were presented as median (IQR) (comparison between groups by the Kruskal Wallis rank sum test) and categorical variables were presented in N (%) (comparison between groups by χ2 test).

The primary endpoint was to determine the effect of TC on the association between MACE and baseline sALB level. Therefore, the results of the analysis of the unadjusted and adjusted covariate models were presented based on the STROBE recommendations. When the covariate was included or excluded from the model, the hazard ratio of the match was changed by at least 10%, and this covariate had to be adjusted23. Also, if related to serum albumin and MACE in clinical practice, the injury covariate should be included with the other congeneric covariates excluded. Additionally, adjusted covariates in previous congener studies were also included.24. And finally we adjusted, if not stratified, for age, sex, BMI, TC, eGFR, ALT in the multivariate model.

In the multivariate regression analysis, the initial level of sALB was first analyzed as a continuous variable and then divided into two groups based on the median level. Interaction tests were performed according to TC (

P values ​​less than 0.05 (two-sided) were considered statistically significant. EmpowerStats ver.3.0 (http://www.empowerstats.net/analysis/, X&Y Solutions, Inc., Boston, MA) and R software ver.3.3.1 (http://www.R-project.org/ , The R Foundation), were used for all statistical analyses.

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