Assessment of C-reactive protein / serum albumin ratio in relation to acute presentation and early outcome of patients with Acute Coronary syndrome

Abstract

Abstract Background: Acute coronary syndrome (ACS) is the leading cardiovascular (CV) cause of mortality . C reactive protein (CRP) has linked with long-term risk of recurrent cardiovascular events or death. Albumin, in contrast to CRP known as negative acute-phase proteins. Thus a newly introduced marker assessed relation of CRP to albumin ratio (CAR), which may provide better results than the use of either marker alone. Aim: - to assess the association of C-reactive protein to albumin ratio (CAR) with in hospital short-term major adverse cardiac events (MACEs) in acute coronary syndrome (ACS) patients. Patients & methods: A multi-centers prospective cohort study conducted at coronary intensive care units (CICU) in Baghdad during the period from March to October 2021 that included a total of 132 patients who were diagnosed as a case of ACS. They were assessed for major adverse cardiac events (MACEs) like cardiogenic shock, arrhythmias, post-MI angina, and acute heart failure while inside the ward, in addition to need for early interventional therapeutic approach in relation to (CAR) immediately at time of admission to hospital. Results: High values of CAR, whether using hs-CRP or CRP, were identified as an independent predictor for in-hospital MACEs (P value < 0.001 and 0.002 respectively. A cut off value of CAR (using hs-CRP) in is 3.18 mg/L in context of discrimination between medically treated ACS patients and death outcome in term of high CAR . A cut off value of CAR (using CRP) as 9.13mg/L suggests the usefulness in discrimination of outcome in relation to medically managed patients , at presentation . CAR had a positive significant correlation with hospital stay (r= 0.210, P =0.036) . Conclusion: The CAR was independently correlated with in-hospital short-term MACEs and can be used for risk stratification in patients with ACS.