Prognostic value of the C-reactive protein to albumin ratio in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction

Prognostic value of the C-reactive protein to albumin ratio in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction

Background/aim: This study investigated whether baseline serum level of C-reactive protein (CRP)/albumin ratio is associated with infarct localization, number of vascular lesions, and in-hospital mortality in patients undergoing primary percutaneous coronary intervention (PCI) for acute ST elevation myocardial infarction (STEMI). Methods: The study population consisted of 116 patients diagnosed with STEMI. The CRP/albumin ratio at first admission, cardiac troponin-I (cTnI), PCI results, and clinical outcomes were recorded. Results: The mean CRP/albumin ratio, cTnI level, and mean number of vascular lesions were significantly higher in non-survivors than in survivors (p = 0.006, p = 0.004, and p = 0.007, respectively). Multivariate logistic regression analysis demonstrated that the CRP/ albumin ratio and number of coronary artery lesions were independent predictors of mortality in STEMI patients. According to these analyses, the presence of ≥ 2 vessel lesions was the most important predictor of mortality, with an odds ratio of 2.009 (95% confidence interval: 1.191–3.387, p = 0.009). Conclusion: This study demonstrates the potential utility of the CRP/albumin ratio for predicting the clinical outcome of patients with STEMI. In addition, the presence of ≥ 2 vascular lesions contributed to a 2-fold increase in mortality rate in STEMI patients.Key words: CRP/albumin ratio, infarction localization, prognosis, ST-elevation myocardial infarction, vascular lesion number

___

  • 1. Mc Namara K, Alzubaidi H, Jackson JK. Cardiovascular disease as a leading cause of death: how are pharmacists getting involved? Integrated Pharmacy Research & Practice 2019; 8: 1-11. doi: 10.2147/IPRP.S133088
  • 2. Shrivastava AK, Singh HV, Raizada A, Singh SK. C-reactive protein, inflammation and coronary heart disease. The Egyptian Heart Journal 2015; 67 (2): 89-97. doi: 10.1016/j. ehj.2014.11.005
  • 3. Francula-Zaninovic S, Nola IA. Management of measurable variable cardiovascular disease’ risk factors. Current Cardiology Reviews 2018; 14 (3): 153-163. doi: 10.2174/1573403X14666180222102312
  • 4. Madjid M and Willerson JT. Inflammatory markers in coronary heart disease. British Medical Bulletin 2011; 100 (1): 23-38. doi: 10.1093/bmb/ldr043
  • 5. Wang J, Tan GJ, Han LN, Bai YY, He M et al. Novel biomarkers for cardiovascular risk prediction. Journal of Geriatric Cardiology 2017; 14 (2): 135-150. doi: 10.11909/j.issn.1671- 5411.2017.02.008
  • 6. Danesh J, Wheeler JG, Hirschfield GM, Eda S, Eiriksdottir G et al. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. The New England Journal of Medicine 2004; 350 (14): 1387-1397. doi: 10.1056/NEJMoa032804
  • 7. Calabrò P, Golia E, Yeh ET. Role of C-reactive protein in acute myocardial infarction and stroke: possible therapeutic approaches. Current Pharmaceutical Biotechnology 2012; 13 (1): 4-16. doi: 10.2174/138920112798868764
  • 8. Arques S. Human serum albumin in cardiovascular diseases. European Journal of Internal Medicine 2018; 52: 8-12. doi: 10.1016/j.ejim.2018.04.014
  • 9. Arques S. Serum albumin and cardiovascular diseases: a comprehensive review of the literature. Annales de Cardiologie et D’angéiologie 2018; 67 (2): 82-90. doi: 10.1016/j. ancard.2018.02.002
  • 10. Nelson JJ, Liao D, Sharrett AR, Folsom AR, Chambless LE et al. Serum albumin level as a predictor of incident coronary heart disease: the Atherosclerosis Risk in communities (ARIC) study. American Journal of Epidemiology 2000; 151 (5): 468-477. doi: 10.1093/oxfordjournals.aje.a010232
  • 11. Djoussé L, Rothman KJ, Cupples LA, Levy D, Ellison RC. Effect of serum albumin and bilirubin on the risk of myocardial infarction (the Framingham offspring study). The American Journal of Cardiology 2003; 91 (4): 485-488. doi: 10.1016/s0002- 9149(02)03256-3
  • 12. Gibson DJ, Hartery K, Doherty J, Nolan J, Keegan D et al. CRP/ Albumin ratio: an early predictor of steroid responsiveness in acute severe Ulcerative Colitis. Journal of Clinical Gastroenterology 2018; 52 (6): e48-e52. doi: 10.1097/MCG.0000000000000884
  • 13. Huang SS, Xie DM, Cai YJ, Wu JM, Chen RC et al. C-reactive protein-to-albumin ratio is a predictor of hepatitis B virus related decompensated cirrhosis: time-dependent receiver operating characteristics and decision curve analysis. European Journal of Gastroenterology & Hepatology 2017; 29 (4): 472- 480. doi: 10.1097/MEG.0000000000000807
  • 14. Kaplan M, Ates I, Akpinar MY, Yuksel M, Kuzu UB et al. Predictive value of C-reactive protein/albumin ratio in acute pancreatitis. Hepatobiliary & Pancreatic Diseases International 2017; 16 (4): 424-430. doi: 10.1016/S1499-3872(17)60007-9
  • 15. Kinoshita A, Onoda H, Imai N, Iwaku A, Oishi M et al. The C-reactive protein/albumin ratio, a novel inflammationbased prognostic score, predicts outcomes in patients with hepatocellular carcinoma. Annals of Surgical Oncology 2015; 22 (3): 803-810. doi: 10.1245/s10434-014-4048-0
  • 16. Lee KJ, Kim HM, Choi JS, Kim YJ, Kim YS, Cho JH. Comparison of predictive systems in severe acute pancreatitis according to the revised Atlanta classification. Pancreas 2016; 45 (1): 46-50. doi: 10.1097/MPA.0000000000000433
  • 17. Lelubre C, Anselin S, Zouaoui Boudjeltia K, Biston P, Piagnerelli M. Interpretation of C-reactive protein concentrations in critically ill patients. BioMed Research International 2013; 2013: 124021. doi: 10.1155/2013/124021
  • 18. Oduncu V, Erkol A, Karabay CY, Kurt M, Akgün T et al. The prognostic value of serum albumin levels on admission in patients with acute ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention. Coronary Artery Disease 2013; 24 (2): 88-94. doi: 10.1097/ MCA.0b013e32835c46fd
  • 19. Wada H, Dohi T, Miyauchi K, Doi S, Naito R et al. Independent and combined effects of serum albumin and C-reactive protein on long-term outcomes of patients undergoing percutaneous coronary intervention. Circulation Journal: Official Journal of the Japanese Circulation Society 2017; 81 (9): 1293-1300. doi: 10.1253/circj.CJ-17-0124
  • 20. Zhou T, Zhan J, Hong S, Hu Z, Fang W et al. Ratio of C-reactive protein/albumin is an ınflammatory prognostic score for predicting overall survival of patients with small-cell lung cancer. Scientific Reports 2015; 5: 10481. doi: 10.1038/ srep10481
  • 21. Lowe GD. The relationship between infection, inflammation, and cardiovascular disease: an overview. Annals of Periodontology/The American Academy of Periodontology 2001;6(1):1-8. doi: 10.1902/annals.2001.6.1.1
  • 22. Karabağ Y, Çağdaş M, Rencuzogullari I, Karakoyun S, Artaç İ et al. Usefulness of the C-reactive protein/albumin ratio for predicting no-reflow in ST-elevation myocardial infarction treated with primary percutaneous coronary intervention. European Journal of Clinical Investigation 2018; 48 (6): e12928. doi: 10.1111/eci.12928
  • 23. Aksu U, Gulcu O, Aksakal E, Kalkan K, Öztürk M et al. The association between CRP/albumin ratio and in-stent restenosis development in patients with ST-segment elevation myocardial infarction. Journal of Clinical Laboratory Analysis 2019; 33 (4): e22848. doi: 10.1002/jcla.22848
  • 24. Sörensen NA, Neumann JT, Ojeda F, Schäfer S, Magnussen C et al. Relations of sex to diagnosis and outcomes in acute coronary syndrome. Journal of the American Heart Association 2018; 7 (6): e007297. doi: 10.1161/JAHA.117.007297
  • 25. Fox KA, Eagle KA, Gore JM, Steg PG, Anderson FA. The global registry of acute coronary events, 1999 to 2009--GRACE. Heart (British Cardiac Society) 2010; 96 (4): 1095-1101. doi: 10.1136/ hrt.2009.190827
  • 26. Potsch AA, Siqueira Filho AG, Tura BR, Gamarski R, Bassan R et al. C-reactive protein diagnostic and prognostic value in patients presenting at the emergency room with chest pain. Arquivos Brasileiros de Cardiologia 2006; 87 (3): 275-280. doi: 10.1590/s0066-782x2006001600008
  • 27. Kurtul A, Murat SN, Yarlioglues M, Duran M, Ocek AH et al. Usefulness of serum albumin concentration to predict high coronary SYNTAX score and in-hospital mortality in patients with acute coronary syndrome. Angiology 2016; 67 (1): 34- 40. doi: 10.1177/0003319715575220
  • 28. Caliskan Z, Telci Caklili O, Kahraman R, Ozcan FB, Sayar S et al. Does celiac disease impair coronary microvascular circulation: coronary flow velocity reserve of patients with celiac disease. Echocardiography 2020; 37(1): 34-40. doi: 10.1111/echo.14554
  • 29. Turer AT, Mahaffey KW, Gallup D, Weaver WD, Christenson RH et al. Enzyme estimates of infarct size correlate with functional and clinical outcomes in the setting of ST-segment elevation myocardial infarction. Current Controlled Trials in Cardiovascular Medicine 2005; 6 (1): 12. doi: 10.1186/1468- 6708-6-12
  • 30. Zhao, X, Wang Y, Liu C, Zhou P, Sheng Z et al. Association between variation of troponin and prognosis of acute myocardial ınfarction before and after primary percutaneous coronary ıntervention. Journal of Interventional Cardiology 2020; 2020: 4793178. doi: 10.1155/2020/4793178
  • 31. Ahmad MI, Yadaw BK, Sharma N, Varshney AK, Sharma L et al. Cardiac troponin ı level in stemı and clinical correlation with left ventricular dysfunction in indian population. Journal of Cardiovascular Diseases & Diagnosis 2013; 1 (4): 1000116. doi: 10.4172/2329-9517.1000117
  • 32. Timmis A, Townsend N, Gale CP, Torbica A, Lettino M et al. European Society of Cardiology: cardiovascular disease statistics 2019 (executive summary). European Heart Journal. Quality of Care & Clinical Outcomes 2020; 6 (1): 7-9. doi: 10.1093/ehjqcco/qcz065
  • 33. Veerasamy M, Edwards R, Ford G, Kirkwood T, Newton J et al. Acute coronary syndrome among older patients: a review. Cardiology in Review 2015; 23 (1): 26-32. doi: 10.1097/ CRD.0000000000000016
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

The relationship of extent of initial radiological involvement with the need of intensive care, mortality rates, and laboratory parameters in Covid-19

Selçuk YAYLACI, Aysun ŞENGÜL, Mehmet KÖROĞLU, Hamad DHEİR, Ertuğrul GÜÇLÜ, Oğuz KARABAY, Yusuf AYDEMİR, Yusuf YÜRÜMEZ, Havva KOCAYİĞİT, Özlem AYDEMİR, Ali Fuat ERDEM, Yasemin GÜNDÜZ

The relation between staging fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography metabolic parameters and tumor necrosis rate in pediatric osteosarcoma patients

Aykut Kürşat FİDAN, Gülin UÇMAK, Bedriye Büşra DEMİREL, Hülya EFETÜRK, İpek ÖZTÜRK, Semra DEMİRTAŞ ŞENLİK, Burcu ESEN AKKAŞ, İnci ERGÜRHAN İLHAN

Retrospective evaluation of the pediatric multicystic dysplastic kidney patients: experience of two centers from southeastern Turkey

Mehtap AKBALIK KARA, Caner ALPARSLAN, Aysel TAKTAK

Current community transmission and future perspectives on the COVID-19 process

Seyhan TÜRK, Ümit Yavuz MALKAN, Can TÜRK, Elif Sena TEMİRCİ, Mustafa Çağrı PEKER, İbrahim Celalettin HAZNEDAROĞLU

A sensitive indicator for the severity of COVID-19: thiol

Esra FIRAT OĞUZ, Funda EREN, Meryem Sena AKKUŞ, İhsan ATEŞ, Özcan EREL, Salim NEŞELİOĞLU, Rahmet GÜNER

How safe are children with COVID-19 from cardiac risks? Pediatric risk assesment; insights from echocardiography and electrocardiography

Berna Şaylan ÇEVİK, Eda KEPENEKLİ, Şule ARICI, Nurhayat YAKUT, Zeynep ERGENÇ, Özge GÜNAL

Effects of intraoperative blood loss during liver resection on patients’ outcome: a singlecenter experience

Erdem KARABULUT, Adnan ÇALIK, Davut DOHMAN, Şükrü OĞUZ, Kadir TOMAS, Muhammed Selim BODUR, Serdar TOPALOĞLU, Hakan KÜÇÜKASLAN

Severe chronic periodontitis is not common in Acromegaly: Potential protective role of gingival BMP-2

0000-0001-5305-6807, Neslihan BAŞÇIL TÜTÜNCÜ, Melek Eda ERTÖRER, Sibel BAŞÇIL, Nilüfer BAYRAKTAR

Turkish validity and reliability study of type 2 diabetes stigma assessment scale

Bahar İNKAYA, Ezgi KARADAĞ

Evaluation of schwannoma using the 3D-SPACE sequence: comparison with the 3D-CISS sequence in 3T-MRI

Murat UÇAR, İsmail AKDULUM, Enes GÜRÜN, Pınar KILIÇ, Nil TOKGÖZ