The association between C-reactive protein/albumin ratio and aortic arch calcification in acute coronary syndrome patients

Abstract

Purpose: We evaluated the association between the severity of aortic arch calcification (AAC) and C-reactive protein/albumin ratio (CAR) in acute coronary syndrome (ACS) patients. Materials and Methods: 288 patients who presented with ACS and underwent coronary angiography were enrolled analysis. CAR was calculated as serum CRP/albumin x 10. The AAC was separated into four groups (0 to 3): Grade 0-1 AAC was defined as the non-severe AAC group, and those with grade 2-3 AAC were defined as the severe AAC group. Results: CRP and CAR were significantly higher in the severe AAC group than in the non-severe AAC group. Multivariate analysis determined that CAR and age were positively associated in ACS patients as an independent predictor of severe AAC. CAR area under the curve (AUC) and CRP AUC demonstrated parallel curves compared to albumin levels, indicating higher statistical significance. The AUC for albumin was 0.349 (95% CI: 0.286-0.413). The AUC for CAR was 0.695, 95% CI 0.625 to 0.753, for CRP the AUC was 0.684 (95% CI: 0.620-0.748). After stratification into 2 groups according to the CAR cut-off value (1.664), the rate of severe AAC was importantly often in high CAR patients compared to in low CAR patients (56.7% vs 23.7%). Conclusion: CAR, an easily calculable, repeatable, and valid surrogate marker of inflammation, can be used reliably to indicate severe AAC in ACS patients.