The association of preprocedural C-reactive protein/albumin ratio with in-stent restenosis in patients undergoing iliac artery stenting

Abstract

Introduction: In-stent restenosis (ISR) still constitutes a major problem after percutaneous vascular interventions and the inflammation has a pivotal role in the pathogenesis of such event. The C-reactive protein/albumin ratio (CAR) is a newly identified inflammatory biomarker, and it may be used as an indicator to predict ISR in subjects with coronary artery stenting. In light of these data, our main objective was to investigate the relationship between the preprocedural CAR and ISR in patients undergoing successful iliac artery stent implantation. Methods: In total, 138 consecutive patients who had successful iliac artery stent implantation in a tertiary heart center between 2015 and 2018 were enrolled in the study. The study population was categorized into two groups; patients with ISR and those without ISR during follow-up. The CAR was determined by dividing CRP by serum albumin. Results: In the multivariable regression analysis; the CAR (HR: 2.66, 95% CI: 1.66-4.25, P < 0.01), stent length (HR: 1.01, 95% CI: 0.99-1.02, P = 0.04), and HbA1c levels (HR: 1.22, 95% CI: 0.99-1.51, P = 0.04) were independently related with ISR. A receiver operating curve analysis displayed that the CAR value of >0.29 predicted ISR with sensitivity of 97.5% and specificity of 88.8% (AUC 0.94, P < 0.01). Conclusion: Our findings provide evidence that the CAR may be an applicable inflammatory biomarker in predicting ISR in subjects undergoing iliac artery stenting for the treatment of peripheral artery disease (PAD). Also, the stent length and poor glycemic control were found to be associated with ISR.

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

“…The increased C-reactive protein-to-albumin ratio (CAR) was shown to be a valuable inflammatory marker predicting ISR in patients undergoing iliac artery stenting (HR 2.66, 95% CI 1.66-4.25; p < 0.01) [56], as well as in patients with STEMI (OR 2.289, 95% CI 1.056-4.959; p = 0.036) [57].…”

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

“…7,8 cardiac diseases. [9][10][11][12][13] However, whether high-sensitivity Creactive protein to albumin ratio (CAR) can predict long-term prognosis in CHD patients undergoing percutaneous coronary intervention (PCI) remains unclear. Hence, the present study explores the association between CAR and long-term adverse cardiovascular outcomes in CHD patients undergoing drugeluting stent (DES) implantation.…”

“…Recently, a novel marker, the CRP to albumin ratio, an index of inflammation status, was shown to be associated with poor prognosis in patients with cardiac diseases and non-cardiac diseases. 9–13 However, whether high-sensitivity C-reactive protein to albumin ratio (CAR) can predict long-term prognosis in CHD patients undergoing percutaneous coronary intervention (PCI) remains unclear. Hence, the present study explores the association between CAR and long-term adverse cardiovascular outcomes in CHD patients undergoing drug-eluting stent (DES) implantation.…”

Relationship Between C-Reactive Protein to Albumin Ratio and Coronary Collateral Circulation in Patients With Stable Coronary Artery Disease

“…13,14 Several studies have demonstrated that the C-reactive protein (CRP)/albumin ratio (CAR), a recently introduced marker of inflammation, is superior to CRP and albumin levels alone in determining the inflammatory condition in cardiovascular diseases. 15–17 Little is known, however, about the association of CAR levels with coronary collaterals. In this study, we examined the relation between CAR and the development of CCC in patients with stable CAD with CTO.…”