Document Detail

Serum albumin and short-term risk for mortality and cardiovascular disease among HIV-infected veterans.
MedLine Citation:
PMID:  23343914     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We examined the short-term and long-term associations of serum albumin with mortality and cardiovascular disease among HIV-infected veterans.
DESIGN: Retrospective cohort analysis using a national database of US veterans with HIV infection.
METHODS: This analysis evaluated all HIV-infected veterans in the Department of Veterans Affairs HIV Clinical Case Registry (CCR), a national database consisting of demographic, clinical, laboratory, pharmaceutical, and viral status data. There were 25 522 patients enrolled between 1986 and 2007. We evaluated the associations of baseline and time-updated serum albumin levels with all-cause mortality, atherosclerotic cardiovascular disease, and heart failure by multivariate proportional hazards models.
RESULTS: Over 21 years, there were 10 869 deaths; the cumulative mortality was 73.2 per 1000 person-years. After multivariate adjustment for covariates measured at baseline, the lowest category of serum albumin (<2.5 g/dl) was associated with a higher mortality risk compared with the highest category (>4 g/dl; hazard ratio 3.00; 2.67-3.37). When analyzed as a time-dependent model, the association strengthened substantially (15.1; 14.0-16.4). Findings were similar for atherosclerotic cardiovascular disease and heart failure. We stratified the baseline mortality model by year of follow-up and found that albumin was more strongly associated with deaths that occurred within 1 year of baseline (9.29; 7.85-11.0) than in the second (1.66; 1.18-2.33) or third (1.22; 0.77-1.96) year after measurement.
CONCLUSION: Among ambulatory HIV-infected patients, lower serum albumin levels are strongly predictive of mortality risk, particularly within 1 year.
Joshua Lang; Rebecca Scherzer; Cristin C Weekley; Phyllis C Tien; Carl Grunfeld; Michael G Shlipak
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  AIDS (London, England)     Volume:  27     ISSN:  1473-5571     ISO Abbreviation:  AIDS     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-08-08     Completed Date:  2013-11-19     Revised Date:  2014-05-21    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  England    
Other Details:
Languages:  eng     Pagination:  1339-43     Citation Subset:  IM; X    
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MeSH Terms
Cardiovascular Diseases / blood,  mortality*
Cohort Studies
HIV Infections / blood,  mortality*
Models, Theoretical
Retrospective Studies
Risk Factors
Serum Albumin / analysis*
Time Factors
United States
Veterans / statistics & numerical data
Grant Support
1 R01 AG034853-01A2/AG/NIA NIH HHS; 1R03AG034871-01/AG/NIA NIH HHS; P30 DK063720/DK/NIDDK NIH HHS; R01 AG034853/AG/NIA NIH HHS; R03 AG034871/AG/NIA NIH HHS
Reg. No./Substance:
0/Serum Albumin

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