Analysis Of Influencing Factors Of The Plasma Albumin Decline In Hospitalized Patients With Cardiovascular Medicine

Objective:To investigate the causes of plasma albumin lower than normal level in hospitalized patients with cardiovascular medicine.Methods:The clinical data of 572 patients admitted to the Department of Cardiology in the Second Hospital of Hebei Medical University from April 2018 to May 2018 were retrospectively analyzed.These data include the patient’s name,gender,age,clinical diagnosis,clinical medication,whether it is blood collection before medication and the first result of plasma albumin after admission.The inclusion criterion of plasma albumin reduction is the plasma albumin result of less than 40.0g/L after admission.Among the patients,265(46.3%)patients are in the plasma albumin reduction group and 307 patients(53.7%)are in the normal plasma albumin group.Using the SPSS 25.0,the chi-square test was used to compare the count data.The multi-factor logistic regression analysis was used to analyze the factors related to the reduction of plasma albumin.Then the propensity score matching(PSM)was used.The function of the logistic regression analysis was based on the nearest neighbor matching method,and the caliper value was set to 0.02,and the samples with the covariate equilibrium between the groups were obtained.The matched samples were again analyzed by chi-square test and logistic regression to influence the factors affecting plasma albumin reduction.Results:According to the results of chi-square test,gender,age,blood collection before medication,heart failure,old myocardial infarction,hyperlipidemia,ischemic stroke,chronic kidney disease,aspirin,P2Y12 receptor antagonist,statins,oral nitrates,angiotensin converting enzyme inhibitors,beta-blockers,loop diuretics,aldosterone receptor antagonists,intravenous nitrate vasodilators,digitalis preparations(Intravenous or oral),other positive inotropic drugs(such as dopamine,etc.),new oral anticoagulants(such as dabigatran,etc.),low molecular weight heparin,creatine phosphate sodium,trimetazidine hydrochloride,pantoprazole(oral)and rabeprazole(intravenous)are all factors affecting albumin results,and P<0.05 is considered to be significantly different.According to Logistic regression analysis,heart failure(OR 2.892,95% CI 1.421-5.884,P=0.003),old myocardial infarction(OR 2.810,95% CI 1.055-7.487,P=0.039),ischemic stroke(OR 2.025,95% CI 1.076-3.811,P=0.029),or the use of intravenous nitrate vasodilators(OR 2.599,95% CI 1.076-6.281,P=0.034),low molecular weight heparin(OR 3.277,95)%CI 2.017-5.324,P=0.000),creatine phosphate sodium(OR 1.662,95% CI 1.057-2.615,P=0.028)are risk factors for lowering plasma albumin in hospitalized patients,And P<0.05 is considered to be significantly different.Patients whose blood samples were taken before medication had a lower risk of plasma albumin decline(OR 0.215,95% CI 0.115-0.404,P=0.000).After the propensity score matching,the result of the chi-square test shows that the application of intravenous nitrate vasodilator or low molecular weight heparin is a factor affecting plasma albumin,and P<0.05 is considered to be have statistical difference.Logistic regression analysis is further performed on the matched samples.The patients whose blood samples were taken before medication still had a lower risk of plasma albumin decline(OR 0.276,95% CI 0.142-0.538,P=0.000);Intravenous nitrate vasodilators(OR 2.950,95% CI 1.070-8.135,P=0.037)and low molecular weight heparin(OR 2.506,95% CI 1.456-4.314,P=0.001)are still risk factors for plasma albumin decline,and P<0.05 is considered to be significantly different;while the difference of creatine phosphate sodium(OR 1.585,95% CI 0.997-2.522,P=0.052)is not an independent risk factor for plasma albumin decline.Conclusion:The risk of plasma albumin decline of patients whose blood samples were taken before administration was lower than the patients whose blood samples were taken after administration,whether before or after propensity score matching.This indicates that the application of certain drugs may be an influencing factor in the decline of plasma albumin levels in hospitalized patients in cardiovascular medicine.Among the results,the intravenous nitrate vasodilators and low molecular weight heparin are more likely,but further experiments are needed to prove their correlation.