Prognostic significance of serum albumin in patients with stable coronary artery disease treated by percutaneous coronary intervention
Stable coronary artery disease (CAD) is known to have an increased risk of cardiovascular events. Serum albumin (Alb) is reported as a useful risk-stratification tool in cardiovascular diseases such as acute coronary syndrome or heart failure. However, the association between Alb and stable CAD is u...
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| creator | Suzuki, Sho Hashizume, Naoto Kanzaki, Yusuke Maruyama, Takuya Kozuka, Ayako Yahikozawa, Kumiko |
| description | Stable coronary artery disease (CAD) is known to have an increased risk of cardiovascular events. Serum albumin (Alb) is reported as a useful risk-stratification tool in cardiovascular diseases such as acute coronary syndrome or heart failure. However, the association between Alb and stable CAD is unclear. Thus, we aimed to investigate the prognostic significance of Alb in patients with stable CAD.
We analyzed the data of all patients admitted to Shinonoi General Hospital between October 2014 and October 2017 for newly diagnosed stable CAD, treated via elective percutaneous coronary intervention, with the exception of old myocardial infarction. We collected data, including Alb, at admission. The primary endpoint was major adverse cardiac events (MACE; defined as all-cause death, non-fatal myocardial infarction, non-fatal stroke). In 204 enrolled patients (median age, 73 years), during a median follow-up of 783 days, 28 experienced MACE. Alb was significantly lower in patients with MACE than in those without (p |
| doi_str_mv | 10.1371/journal.pone.0219044 |
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We analyzed the data of all patients admitted to Shinonoi General Hospital between October 2014 and October 2017 for newly diagnosed stable CAD, treated via elective percutaneous coronary intervention, with the exception of old myocardial infarction. We collected data, including Alb, at admission. The primary endpoint was major adverse cardiac events (MACE; defined as all-cause death, non-fatal myocardial infarction, non-fatal stroke). In 204 enrolled patients (median age, 73 years), during a median follow-up of 783 days, 28 experienced MACE. Alb was significantly lower in patients with MACE than in those without (p<0.001). In Kaplan-Meier analysis, low Alb predicted worse prognosis in MACE (p<0.001). In multivariate Cox regression analysis, low Alb levels independently predicted MACE (p<0.001) after adjusting for age and sex (HR 4.128 [95% CI 1.632-10.440], p = 0.003), or, age and C-reactive protein (HR 3.373 [95% CI 1.289-8.828], p = 0.013).
Low Alb levels predicted MACE in patients with stable CAD.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0219044</identifier><identifier>PMID: 31269058</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Aged ; Aged, 80 and over ; Albumin ; Angioplasty ; Balloon angioplasty ; Biology and Life Sciences ; Biomarkers - blood ; C-reactive protein ; Cardiac patients ; Cardiovascular disease ; Cardiovascular diseases ; Cerebral infarction ; Cohort Studies ; Complications and side effects ; Congestive heart failure ; Coronary angiography ; Coronary artery ; Coronary artery disease ; Coronary Artery Disease - blood ; Coronary Artery Disease - complications ; Coronary Artery Disease - surgery ; Coronary heart disease ; Female ; Health risk assessment ; Health risks ; Heart attack ; Heart attacks ; Heart diseases ; Heart failure ; Humans ; Intervention ; Kaplan-Meier Estimate ; Male ; Medical prognosis ; Medical research ; Medicine and Health Sciences ; Mortality ; Myocardial infarction ; Myocardial Infarction - etiology ; Percutaneous Coronary Intervention ; Prognosis ; Proportional Hazards Models ; Regression analysis ; Retrospective Studies ; Risk Factors ; Serum albumin ; Serum Albumin, Human - metabolism ; Stroke - etiology ; Studies</subject><ispartof>PloS one, 2019-07, Vol.14 (7), p.e0219044-e0219044</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Suzuki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Suzuki et al 2019 Suzuki et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-aa192982ec71c7388810ff73871e83343a320342ff60385a91c18acc58206b463</citedby><cites>FETCH-LOGICAL-c692t-aa192982ec71c7388810ff73871e83343a320342ff60385a91c18acc58206b463</cites><orcidid>0000-0001-9058-9258</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6608965/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6608965/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79472,79473</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31269058$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Lazzeri, Chiara</contributor><creatorcontrib>Suzuki, Sho</creatorcontrib><creatorcontrib>Hashizume, Naoto</creatorcontrib><creatorcontrib>Kanzaki, Yusuke</creatorcontrib><creatorcontrib>Maruyama, Takuya</creatorcontrib><creatorcontrib>Kozuka, Ayako</creatorcontrib><creatorcontrib>Yahikozawa, Kumiko</creatorcontrib><title>Prognostic significance of serum albumin in patients with stable coronary artery disease treated by percutaneous coronary intervention</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Stable coronary artery disease (CAD) is known to have an increased risk of cardiovascular events. Serum albumin (Alb) is reported as a useful risk-stratification tool in cardiovascular diseases such as acute coronary syndrome or heart failure. However, the association between Alb and stable CAD is unclear. Thus, we aimed to investigate the prognostic significance of Alb in patients with stable CAD.
We analyzed the data of all patients admitted to Shinonoi General Hospital between October 2014 and October 2017 for newly diagnosed stable CAD, treated via elective percutaneous coronary intervention, with the exception of old myocardial infarction. We collected data, including Alb, at admission. The primary endpoint was major adverse cardiac events (MACE; defined as all-cause death, non-fatal myocardial infarction, non-fatal stroke). In 204 enrolled patients (median age, 73 years), during a median follow-up of 783 days, 28 experienced MACE. Alb was significantly lower in patients with MACE than in those without (p<0.001). In Kaplan-Meier analysis, low Alb predicted worse prognosis in MACE (p<0.001). In multivariate Cox regression analysis, low Alb levels independently predicted MACE (p<0.001) after adjusting for age and sex (HR 4.128 [95% CI 1.632-10.440], p = 0.003), or, age and C-reactive protein (HR 3.373 [95% CI 1.289-8.828], p = 0.013).
Low Alb levels predicted MACE in patients with stable CAD.</description><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Albumin</subject><subject>Angioplasty</subject><subject>Balloon angioplasty</subject><subject>Biology and Life Sciences</subject><subject>Biomarkers - blood</subject><subject>C-reactive protein</subject><subject>Cardiac patients</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cerebral infarction</subject><subject>Cohort Studies</subject><subject>Complications and side effects</subject><subject>Congestive heart failure</subject><subject>Coronary angiography</subject><subject>Coronary artery</subject><subject>Coronary artery disease</subject><subject>Coronary Artery Disease - blood</subject><subject>Coronary Artery Disease - complications</subject><subject>Coronary Artery Disease - surgery</subject><subject>Coronary heart disease</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Heart attack</subject><subject>Heart attacks</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Humans</subject><subject>Intervention</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Myocardial Infarction - etiology</subject><subject>Percutaneous Coronary Intervention</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Serum albumin</subject><subject>Serum Albumin, Human - metabolism</subject><subject>Stroke - etiology</subject><subject>Studies</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk1trFDEUxwdRbK1-A9GAIPqway5zSV6EUrwsFCreXsOZTGY2y0yyTTLVfgE_t1l3WnekD5JAQvI7_-R_kpNlTwleElaRNxs3egv9cuusXmJKBM7ze9kxEYwuSorZ_YP5UfYohA3GBeNl-TA7YoSWAhf8OPv1ybvOuhCNQsF01rRGgVUauRYF7ccBQV-Pg7Eo9S1Eo20M6IeJaxQi1L1GynlnwV8j8FGnoTFBQ9Aoeg1RN6i-Rlvt1RjBajeGv7yxib9KesbZx9mDFvqgn0zjSfbt_buvZx8X5xcfVmen5wtVChoXAERQwalWFVEV45wT3LZpUhHNGcsZsOQ2p21bYsYLEEQRDkoVnOKyzkt2kj3f6257F-SUwiApLUjFSVWQRKz2RONgI7feDOmu0oGRfxac72QyalSvZVs0AgNXUNQiZxXljco5zTUXTcUK3iStt9NpYz3oRiWvHvqZ6HzHmrXs3JUsS8xFWSSBV5OAd5ejDlEOJijd9_tc7u5NKSeU8IS--Ae9291EdZAMGNu6dK7aicrTQlBCCM3zRC3voFJr9GBU-m-tSeuzgNezgMRE_TN2MIYgV18-_z978X3Ovjxg1xr6uA6uH3dfJszBfA8q70Lwur1NMsFyVy432ZC7cpFTuaSwZ4cPdBt0Ux_sN2CfEU8</recordid><startdate>20190703</startdate><enddate>20190703</enddate><creator>Suzuki, Sho</creator><creator>Hashizume, Naoto</creator><creator>Kanzaki, Yusuke</creator><creator>Maruyama, Takuya</creator><creator>Kozuka, Ayako</creator><creator>Yahikozawa, Kumiko</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-9058-9258</orcidid></search><sort><creationdate>20190703</creationdate><title>Prognostic significance of serum albumin in patients with stable coronary artery disease treated by percutaneous coronary intervention</title><author>Suzuki, Sho ; Hashizume, Naoto ; Kanzaki, Yusuke ; Maruyama, Takuya ; Kozuka, Ayako ; Yahikozawa, Kumiko</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-aa192982ec71c7388810ff73871e83343a320342ff60385a91c18acc58206b463</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Albumin</topic><topic>Angioplasty</topic><topic>Balloon angioplasty</topic><topic>Biology and Life Sciences</topic><topic>Biomarkers - blood</topic><topic>C-reactive protein</topic><topic>Cardiac patients</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Cerebral infarction</topic><topic>Cohort Studies</topic><topic>Complications and side effects</topic><topic>Congestive heart failure</topic><topic>Coronary angiography</topic><topic>Coronary artery</topic><topic>Coronary artery disease</topic><topic>Coronary Artery Disease - blood</topic><topic>Coronary Artery Disease - complications</topic><topic>Coronary Artery Disease - surgery</topic><topic>Coronary heart disease</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Health risks</topic><topic>Heart attack</topic><topic>Heart attacks</topic><topic>Heart diseases</topic><topic>Heart failure</topic><topic>Humans</topic><topic>Intervention</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medicine and Health Sciences</topic><topic>Mortality</topic><topic>Myocardial infarction</topic><topic>Myocardial Infarction - etiology</topic><topic>Percutaneous Coronary Intervention</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Serum albumin</topic><topic>Serum Albumin, Human - metabolism</topic><topic>Stroke - etiology</topic><topic>Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Suzuki, Sho</creatorcontrib><creatorcontrib>Hashizume, Naoto</creatorcontrib><creatorcontrib>Kanzaki, Yusuke</creatorcontrib><creatorcontrib>Maruyama, Takuya</creatorcontrib><creatorcontrib>Kozuka, Ayako</creatorcontrib><creatorcontrib>Yahikozawa, Kumiko</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Opposing Viewpoints in Context (Gale)</collection><collection>Science (Gale in Context)</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Suzuki, Sho</au><au>Hashizume, Naoto</au><au>Kanzaki, Yusuke</au><au>Maruyama, Takuya</au><au>Kozuka, Ayako</au><au>Yahikozawa, Kumiko</au><au>Lazzeri, Chiara</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic significance of serum albumin in patients with stable coronary artery disease treated by percutaneous coronary intervention</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-07-03</date><risdate>2019</risdate><volume>14</volume><issue>7</issue><spage>e0219044</spage><epage>e0219044</epage><pages>e0219044-e0219044</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Stable coronary artery disease (CAD) is known to have an increased risk of cardiovascular events. Serum albumin (Alb) is reported as a useful risk-stratification tool in cardiovascular diseases such as acute coronary syndrome or heart failure. However, the association between Alb and stable CAD is unclear. Thus, we aimed to investigate the prognostic significance of Alb in patients with stable CAD.
We analyzed the data of all patients admitted to Shinonoi General Hospital between October 2014 and October 2017 for newly diagnosed stable CAD, treated via elective percutaneous coronary intervention, with the exception of old myocardial infarction. We collected data, including Alb, at admission. The primary endpoint was major adverse cardiac events (MACE; defined as all-cause death, non-fatal myocardial infarction, non-fatal stroke). In 204 enrolled patients (median age, 73 years), during a median follow-up of 783 days, 28 experienced MACE. Alb was significantly lower in patients with MACE than in those without (p<0.001). In Kaplan-Meier analysis, low Alb predicted worse prognosis in MACE (p<0.001). In multivariate Cox regression analysis, low Alb levels independently predicted MACE (p<0.001) after adjusting for age and sex (HR 4.128 [95% CI 1.632-10.440], p = 0.003), or, age and C-reactive protein (HR 3.373 [95% CI 1.289-8.828], p = 0.013).
Low Alb levels predicted MACE in patients with stable CAD.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31269058</pmid><doi>10.1371/journal.pone.0219044</doi><tpages>e0219044</tpages><orcidid>https://orcid.org/0000-0001-9058-9258</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2019-07, Vol.14 (7), p.e0219044-e0219044 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2251781751 |
| source | MEDLINE; Public Library of Science; DOAJ Directory of Open Access Journals; PubMed Central; Free Full-Text Journals in Chemistry; EZB Electronic Journals Library |
| subjects | Age Aged Aged, 80 and over Albumin Angioplasty Balloon angioplasty Biology and Life Sciences Biomarkers - blood C-reactive protein Cardiac patients Cardiovascular disease Cardiovascular diseases Cerebral infarction Cohort Studies Complications and side effects Congestive heart failure Coronary angiography Coronary artery Coronary artery disease Coronary Artery Disease - blood Coronary Artery Disease - complications Coronary Artery Disease - surgery Coronary heart disease Female Health risk assessment Health risks Heart attack Heart attacks Heart diseases Heart failure Humans Intervention Kaplan-Meier Estimate Male Medical prognosis Medical research Medicine and Health Sciences Mortality Myocardial infarction Myocardial Infarction - etiology Percutaneous Coronary Intervention Prognosis Proportional Hazards Models Regression analysis Retrospective Studies Risk Factors Serum albumin Serum Albumin, Human - metabolism Stroke - etiology Studies |
| title | Prognostic significance of serum albumin in patients with stable coronary artery disease treated by percutaneous coronary intervention |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T15%3A36%3A09IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prognostic%20significance%20of%20serum%20albumin%20in%20patients%20with%20stable%20coronary%20artery%20disease%20treated%20by%20percutaneous%20coronary%20intervention&rft.jtitle=PloS%20one&rft.au=Suzuki,%20Sho&rft.date=2019-07-03&rft.volume=14&rft.issue=7&rft.spage=e0219044&rft.epage=e0219044&rft.pages=e0219044-e0219044&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0219044&rft_dat=%3Cgale_plos_%3EA592111244%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2251781751&rft_id=info:pmid/31269058&rft_galeid=A592111244&rft_doaj_id=oai_doaj_org_article_f5d90a8ca5b943728dc4824e89d7358d&rfr_iscdi=true |