Abstract 10314: Clinical Impact of C-Reactive Protein to Albumin Ratio on Prognosis in Patients With Stable Coronary Artery Disease After Percutaneous Coronary Intervention

Abstract

Background : The C-reactive protein/albumin (CRP/Alb) ratio is known to be a novel marker of inflammation and is associated with outcome in septic patients. However, the effect of CRP/Alb ratio for clinical outcomes in patients with stable coronary artery disease (CAD) after percutaneous coronary intervention (PCI) has not been well evaluated. Methods : The subject comprised 500 consecutive stable angina patients who underwent successfully elective PCI using second-generation drug-eluting stents and intravascular ultrasound. We investigated between the clinical factors including CRP/Alb ratio and the incidences of both all-cause death and major cardiovascular and cerebrovascular events (MACCE). Results: Median of age was 69 years (62-76) and 356 cases (71%) were male. Thirty-seven patients (7%) died after PCI, and the incidence of MACCE including all-cause death was 47 cases (9%). Age, dyslipidemia, hemodialysis, statin use , estimated glomerular filtration rate and CRP/Alb ratio correlated significantly with all-cause death and MACCEin the univariate cox proportional hazards analysis. A multivariate Cox proportional hazards regression analysis modeling relevant factors from univariate analysis showed CRP/Alb ratio was significantly associated with both all-cause death (HR: 1.24, 95%CI: 1.11-1.35, p<0.001) and MACCE (HR: 1.21, 95%CI: 1.09-1.32, p<0.001). The optimal cut-off on the receiver-operating characteristic curve of CRP/Alb ratio for predicting for all-cause death and MACCE were both 0.30 [all-cause death; the area under the curve (AUC) = 0.75, Sensitivity = 57%, Specificity = 87%, p<0.001 and MACCE; AUC = 0.73, Sensitivity = 49%, Specificity = 87%, p<0.001). Kaplan-Meier analysis showed a significantly lower survival rate after PCI in low CRP/Alb ratio (< 0.30) group than high CRP/Alb ratio (≥ 0.30) group (p<0.001). Similarly, cumulative incidence of MACCE was significantly higher in the high CRP/Alb ratio group than in the low CRP/Alb ratio group (p<0.001). Conclusion: The CRP/Alb ratio may have a potential for predicting the all-cause death and MACCE in patients with stable CAD after PCI.