Assessment of the relation between C-reactive protein to albumin ratio and the severity and complexity of peripheral arterial disease

Süleymanoğlu, Muhammed; Burak, Cengiz; Gümüşdağ, Ayça; Yesi̇n, Mahmut; Rencüzoğulları, İbrahim; Karabağ, Yavuz; Çağdaş, Metin; Çap, Murat

doi:10.1177/1708538120925952

Cited by 15 publications

(12 citation statements)

References 33 publications

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“…[29][30][31] Because inflammation is among the well-known underlying mechanisms of atherosclerosis, and CRP and albumin are well-defined inflammatory markers, the CRPto-albumin ratio may better indicate the inflammatory status of a patient. The prognostic value of CAR has been widely reported for various cardiovascular diseases [32][33][34] ; however, the current study is the first to report the role of CAR in the prediction of amputation and all-cause mortality in patients with PAD who have undergone endovascular treatment. The Kaplan-Meier curve showed a higher rate of amputationfree survival and a lower mortality rate in patients with low CAR levels.…”

Section: Discussionmentioning

confidence: 87%

Prognostic value of C-reactive protein to albumin ratio for long-term outcomes of patients with peripheral arterial disease underwent endovascular treatment

et al. 2021

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Background Peripheral artery disease (PAD) is part of the systemic atherosclerotic process that is highly associated with cardiovascular diseases. Despite successful endovascular treatment (EVT) strategies, mortality and morbidity rates still remain higher in PAD patients. C-reactive protein (CRP) and albumin are biomarkers of inflammation and malnutrition that play key roles in the progression of peripheral arterial disease. In this study, we aimed to investigate the relationship between CRP-to-albumin ratio (CAR) and mortality and amputation-free survival in patients with PAD after successful EVT. Method Our study enrolled 149 consecutive patients who underwent EVT on atherosclerotic obstruction of iliac, femoral, popliteal and/or below-knee arteries with the clinical features of PAD and/or chronic limb-threatening ischaemia between January 2015 and January 2020. Clinical and prognostic follow-up of patients had been done at the outpatient clinic and were collected from institution’s medical records. Results The mean follow-up period was 22 months (14–40). All-cause mortality and amputation rates of patients in the high CAR group were significantly higher than those in the low CAR group (21.3% vs. 6.8% and 18.7% vs. 5.4%, respectively). Kaplan–Meier survival analysis showed significantly better survival for patients in the low CAR group (log-rank p = 0.0058). In multivariate logistic regression analysis, CAR was found to be an independent predictor of amputation and all-cause mortality even after adjusting for other confounding risk factors. ROC curve analysis revealed the optimal cut-off value of CAR for predicting all-cause mortality and amputation to be >1.476 with a sensitivity of 48.5% and specificity of 94.0%. Conclusion The inflammatory state reflected by CAR levels was strongly associated with all-cause mortality and amputation after EVT in patients with PAD. Furthermore, CAR was found to be an independent predictor of these clinical outcomes after adjusting for other clinically associated parameters.

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Section: Discussionmentioning

confidence: 87%

Prognostic value of C-reactive protein to albumin ratio for long-term outcomes of patients with peripheral arterial disease underwent endovascular treatment

et al. 2021

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“…CAR in critically ill patients and malignancies is a prognostic factor based on systemic infection [ 29 ]. Süleymanoğlu et al [ 30 ] showed the CAR value as an independent predictor in the prognosis of PAD. In our study, the cut-off value for preop CAR was 2.79 (sensitivity 82%, specificity 23%), and the postop CAR cut-off value was 3.07 (sensitivity 78%, specificity 71%).…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Neutrophil/Albumin Ratio and Early Mortality After Major Lower Extremity Amputation

Günay¹,

Ekici²

2021

Cureus

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IntroductionDiabetic foot infection is a condition that affects the patient's life, may cause limb loss, and has a high mortality. Too many parameters were used for predicting early mortality but the gold standard method wasn't described. Neutrophil lymphocyte ratio (NLR) is universally accepted as a predictive value for amputation-free survival and mortality. NLR increases due to inflammation-induced neutrophilia and lymphopenia related to cortisol-induced stress. Increasing in the neutrophil albumin ratio is expected due to decreasing albumin levels because albumin is a negative acute-phase reactant. The aim of this study is to investigate the sensitivity and value of the neutrophil albumin ratio (NAR) for early mortality after major lower extremity amputation (LEA). MethodsFollowing the approval of the ethics committee, 87 patients who underwent major LEA between May 2018 and May 2020 were analyzed for the study. White blood cell (WBC), neutrophil, lymphocyte, C-reactive protein (CRP), creatinine, albumin, platelet, and hemoglobin values on the day prior to surgery were recorded. NLR was calculated as the ratio of neutrophil count to lymphocyte count, NAR as the ratio of neutrophil count to albumin value, CRP/albumin ratio (CAR) as the ratio of CRP value to albumin value, and platelet lymphocyte ratio (PLR) as the ratio of platelet count to lymphocyte count. Each parameter was also recorded in the postoperative second week. ResultsOf the patients included in the study, 52 were men (59.8%) and 35 were women (40.2%). It was determined that 29 of 87 patients (33.3%) died within the first year. The relationship between post-operative NAR value and early mortality is examined. The area under the curve was calculated as 0.873. When the cut-off value was applied as 0.265, the sensitivity was found as 88% and specificity as 76%. ConclusionsHigher neutrophil/albumin ratio after lower extremity amputation was associated with early mortality after extremity amputation. This parameter can help predict mortality. The cut-off value was determined as 0.265, the sensitivity was found as 88%, and specificity as 76%.

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“…[29][30][31] Süleymanoglu et al showed that serum CAR was a more accurate marker than CRP or albumin alone in predicting more severe and complex lesions in patients with peripheral arterial disease. 32 Vele et al suggested that patients with AAA have higher D-dimer levels compared with a nonaneurysmal group. Moreover, the higher levels of D-dimer correlated with progression of AAA.…”

Section: Discussionmentioning

confidence: 99%

Association of C-Reactive Protein-to-Albumin Ratio With the Presence and Progression of Abdominal Aortic Aneurysm

Çerşit¹,

Öcal²,

Keskin³

et al. 2020

Angiology

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Aortic dilatation due to inflammation may lead to an increase in C-reactive protein (CRP) levels. We investigated the possible relationship between CRP-to-albumin ratio (CAR) and presence and progression of abdominal aortic aneurysms (AAAs). The study included 150 patients previously diagnosed with AAA (diameter 40-54 mm) and 100 normal controls. Clinical and laboratory parameters and maximal cross-sectional AAA diameters (measured by computed tomography angiography) were obtained from all participants at baseline assessment as well as after 1 year for those with an AAA. The patients with AAA had significantly higher serum CAR compared with controls at baseline (P < .001). Increased serum CAR was found to be an independent predictor of the presence of AAA (odds ratio: 3.162, 95% CI: 1.690-5.126, P = .001) after multivariate logistic regression analysis. There was a significant increase in aortic diameter and CAR after 1 year in the patients with AAA ( P < .001; P = .003); a significant correlation was found between changes in the diameter of AAAs and CAR ( r = 0.414; P = .005). Serum CAR may be useful as an inflammatory biomarker for the presence and progression of AAA.

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Assessment of the relation between C-reactive protein to albumin ratio and the severity and complexity of peripheral arterial disease

Cited by 15 publications

References 33 publications

Prognostic value of C-reactive protein to albumin ratio for long-term outcomes of patients with peripheral arterial disease underwent endovascular treatment

Prognostic value of C-reactive protein to albumin ratio for long-term outcomes of patients with peripheral arterial disease underwent endovascular treatment

Relationship Between Neutrophil/Albumin Ratio and Early Mortality After Major Lower Extremity Amputation

Association of C-Reactive Protein-to-Albumin Ratio With the Presence and Progression of Abdominal Aortic Aneurysm

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