摘要BACKGROUND Prealbumin is considered to be a useful indicator of nutritional status.Furthermore,it has been found to be associated with severities and prognosis of a range of diseases.However,limited data on the association of baseline prealbumin level with outcomes of patients with acute ST-segment elevation myocardial infarction(STEMI)are available.METHODS We analyzed 2313 patients admitted for acute STEMI between October 2013 and December 2020.In-hospital out-comes and mortality during the 49 months(interquartile range:26-73 months)follow-up period were compared between pati-ents with the low prealbumin level(＜170 mg/L)and those with the high prealbumin level(≥170 mg/L).RESULTS A total of 114 patients(4.9％)died during hospitalization.After propensity score matching,patients with the low pre-albumin level than those with the high prealbumin level experienced higher incidences of heart failure with Killip class Ⅲ(9.9％vs.4.4％,P=0.034),cardiovascular death(8.4％vs.3.4％,P=0.035)and the composite of major adverse cardiovascular events(19.2％vs.10.3％,P=0.012).Multivariate logistic regression analysis identified that the low prealbumin level(＜170 mg/L)was an inde-pendent predictor of in-hospital major adverse cardiovascular events(odds ratio=1.918,95％CI:1.250-2.942,P=0.003).The cut-off value of prealbumin level for predicting in-hospital death was 170 mg/L(area under the curve=0.703,95％CI:0.651-0.754,P＜0.001;sensitivity=0.544,specificity=0.794).However,after multivariate adjustment of possible confounders,baseline prealbu-min level(170 mg/L)was no longer independently associated with 49-month cardiovascular death.After propensity score match-ing,Kaplan-Meier survival curves revealed consistent results.CONCLUSIONS Decreased prealbumin level closely related to unfavorable short-term outcomes.However,after multivariate adjustment and controlling for baseline differences,baseline prealbumin level was not independently associated with an incr-eased risk of long-term cardiovascular mortality in STEMI patients.