The Usefulness of C-Reactive Protein to Albumin Ratio in the Prediction of Adverse Cardiovascular Events in Coronary Chronic Total Occlusion Undergoing Percutaneous Coronary Intervention

Lele Cheng; Zixuan Meng; Qi Wang; Zhijie Jian; Pengcheng Fan; Xinxin Feng; Xiangrui Qiao; Jian Yang; Zuyi Yuan; Bolin Li; Yue Wu

doi:10.3389/fcvm.2021.731261

The Usefulness of C-Reactive Protein to Albumin Ratio in the Prediction of Adverse Cardiovascular Events in Coronary Chronic Total Occlusion Undergoing Percutaneous Coronary Intervention

Front Cardiovasc Med. 2021 Nov 12:8:731261. doi: 10.3389/fcvm.2021.731261. eCollection 2021.

Authors

Lele Cheng^{1

2

3

4}, Zixuan Meng¹, Qi Wang⁵, Zhijie Jian², Pengcheng Fan¹, Xinxin Feng¹, Xiangrui Qiao^{1

3

4}, Jian Yang², Zuyi Yuan^{1

3

4}, Bolin Li^{1

3

4}, Yue Wu¹

Affiliations

¹ Department of Cardiovascular Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
² Department of Medical Imaging, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
³ Key Laboratory of Molecular Cardiology, Xi'an, China.
⁴ Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, China.
⁵ First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China.

Abstract

Inflammation and nutrition as main factors can affect the prognosis of patients with chronic total coronary occlusion (CTO) undergoing percutaneous coronary intervention (PCI). The C-reactive protein to albumin ratio (CAR) can clarify the inflammation and nutrition status, which are highly related to clinical outcomes. This study aims to investigate the association between CAR and adverse cardiovascular events in patients with CTO undergoing PCI. For this study, 664 patients were divided into three groups based on the tertiles of CAR. The primary endpoint was all-cause mortality and the secondary endpoint was major adverse cardiovascular events (MACE). Over a median follow-up of 33.7 months, the primary endpoint occurred in 64 patients (9.6%) and the secondary endpoint occurred in 170 patients (25.6%). The patients with higher CAR represented a worse prognosis with all-cause death and cardiovascular death after the adjustment for the baseline risk factors. Adding the CAR values raised the predictive value for the incidence of the all-cause death and cardiovascular death but not MACE. The capacity of prognosis prediction was improved after the addition of the CAR value to the traditional prediction model.

Keywords: adverse cardiovascular events; c-reactive protein to albumin ratio; chronic coronary total occlusion; percutaneous coronary intervention; prognostic indicator.