The Association Between High-Sensitivity C-Reactive Protein/Albumin Ratio and Cardiovascular Prognosis in Patients Undergoing Percutaneous Coronary Intervention

Yang²,

J Epidemiol Community Health

et al. 2023

BackgroundThe high levels of C reactive protein (CRP) to albumin ratio (CAR) is thought to increase the risk of poor outcomes for cancer and cardiovascular disease (CVD). However, the association between CAR and CVD in the Chinese community population has not been investigated.ObjectiveThe aim of this study was to investigate the association between CAR and CVD in the Chinese community population.MethodsA total of 62 067 participants without a history of CVD or cancer were included in this study. Kaplan-Meier survival curves were used to calculate the cumulative incidence of endpoint events in CAR quartile groups, and the results were tested by log-rank test. Fine-Gray model was used to analyse the competing risk of death. C-index, Net Reclassification Index (NRI) and Integrated Discrimination Improvement Index (IDI) of different indicators were calculated to distinguish the predictive performance of different indicators.ResultsDuring an average follow-up period of 10.3±2.1 years, 4025 participants developed CVD. In multivariable Cox regression analysis, compared with Q1 group, model 3 showed that the hazard ratio (HR) (95% confidence interval (95%CI)) of CVD in Q4 group was 1.26 (1.15 to 1.38) (p<0.01), and the HR (95% CI) per 1 SD increase was 1.06 (1.03 to 1.08) (p<0.01). The C-index, continuous NRI and IDI for predicting 10-year CVD were 73.48%, 0.1366 (0.1049 to 0.1684) (p<0.01) and 0.0002 (0.0001 to 0.0004) (p<0.01), respectively, which were higher than those of hs-CRP (C-index:0.7344, NRI:0.0711, IDI: 0.0001) and albumin (C-index:0.7339, NRI: −0.0090, IDI: 0.0000).ConclusionHigh levels of CAR can increase the risk of CVD and the predictive performance of CAR for CVD is better than that of hs-CRP or albumin alone.

Section: Discussionsupporting

confidence: 94%

High levels of high-sensitivity C reactive protein to albumin ratio can increase the risk of cardiovascular disease

Yang²,

J Epidemiol Community Health

et al. 2023

“…In other recent investigations, CRP was not considered the sole marker but rather in interaction with other factors. In a Chinese study, the importance of CRP to albumin ratio as an independent predictor of major adverse cardiac and cerebrovascular events and MI CVD patients was highlighted ( n = 9375, follow-up period = 2 years) [ 40 ]. In another large-scale prospective cohort study, the elevation of both Lp(a) and CRP was associated with a significantly higher risk of major adverse cardiac and cerebrovascular events ( n = 10,424; follow-up period = 5 years) [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

C-Reactive Protein Level and the Genetic Variant rs1130864 in the CRP Gene as Prognostic Factors for 10-Year Cardiovascular Outcome

Schulz

Rehm

Schlitt

et al. 2023

Cells

Background: Cardiovascular disease (CVD) is the primary cause of premature death and disability worldwide. There is extensive evidence that inflammation represents an important pathogenetic mechanism in the development and prognosis of CVD. C-reactive protein (CRP) is a potential marker of vascular inflammation and plays a direct role in CVD by promoting vascular inflammation. The objective of this study (ClinTrials.gov identifier: NCT01045070) was to assess the prognostic impact of CRP protein levels and genetic variants of CRP gene events on cardiovascular (CV) outcome (10-year follow-up) in patients suffering from CVD. Methods: CVD patients were prospectively included in this study (n = 1002) and followed up (10 years) regarding combined CV endpoint (CV death, death from stroke, myocardial infarction (MI), and stroke/transient ischemic attack (TIA)). CRP protein level (particle-enhanced immunological turbidity test) and genetic variants (rs1130864, rs1417938, rs1800947, rs3093077; polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) after DNA extraction from EDTA-blood) were evaluated. Results: In survival analyses, increased CRP protein levels of ≥5 mg/L (log-rank test: p < 0.001, Cox regression: p = 0.002, hazard ratio = 1.49) and CT + TT genotype of rs1130864 (log-rank test: p = 0.041; Cox regression: p = 0.103, hazard ratio = 1.21) were associated with a weaker CV prognosis considering combined CV endpoint. Conclusions: Elevated CRP level and genetic variant (rs1130864) were proven to provide prognostic value for adverse outcome in CVD patients within the 10-year follow-up period.

“…Therefore, abnormal lipid metabolism, abnormal function of immune cells, and inflammatory cytokine release are associated with CAD prognosis. Yang has demonstrated that MACCEs and MI in patients receiving PCI are independently predicted by the ratio of high-sensitivity C-reactive protein to albumin [27]. IL-1β is involved in pancreatic cell destruction and can be used to predict CVD risk in people with T2DM [28].…”

Section: Discussionmentioning

confidence: 99%

Combination of Neutrophil Count and Gensini Score as a Prognostic Marker in Patients with ACS and Uncontrolled T2DM Undergoing PCI

Xu¹,

Qin²,

Gao³

et al. 2023

CVIA

Background: Several biomarkers have been studied as prognostic indicators among people with diabetes and coronary artery disease (CAD). The purpose of this study was to determine the prognostic value of neutrophil counts and the Gensini score in patients with diabetes and ACS undergoing percutaneous coronary intervention (PCI). Methods: A total of 694 people with ACS and T2DM who simultaneously had elevated HBA1c received PCI. Spearman rank correlation estimates were used for correlation evaluation. Multivariate Cox regression and Kaplan-Meier analysis were used to identify characteristics associated with major adverse cardiovascular and cerebrovascular events (MACCEs) and patient survival. The effects of single- and multi-factor indices on MACCEs were evaluated through receiver operating characteristic curve analysis. Results: The Gensini score and neutrophil count significantly differed between the MACCE and non-MACCE groups among patients receiving PCI who had concomitant ACS and T2DM with elevated HBA1c (P<0.001). The Gensini score and neutrophil count were strongly associated with MACCEs (log-rank, P<0.001). The Gensini score and neutrophil count, alone or in combination, were predictors of MACCEs, according to multivariate Cox regression analysis (adjusted hazard ratio [HR], 1.005; 95% confidence interval [CI], 1.002–1.008; P=0.002; adjusted HR, 1.512; 95% CI, 1.005–2.274; P=0.047, respectively). The Gensini score was strongly associated with neutrophil count (variance inflation factor ≥ 5). Area under the curve analysis revealed that the combination of multivariate factors predicted the occurrence of MACCEs better than any single variable. Conclusion: In patients with T2DM and ACS with elevated HBA1c who underwent PCI, both the Gensini score and neutrophil count were independent predictors of outcomes. The combination of both predictors has a higher predictability.