What is the clinical evidence from this study?

Study design: Observational. Population: Non-ST-elevation myocardial infarction (n=297). Intervention: C-reactive protein/albumin ratio. Primary outcome: In-hospital mortality (OR 0.812, 95% CI 0.661-0.998, p=0.048).

March 1, 2023Open Access

The Relationship of the C-Reactive Protein /Albumin Ratio to in-Hospital Mortality in Elderly Patients With Non-St-Elevation Myocardial Infarction Who Have Undergone Percutaneous Coronary Intervention

Key Result

The C-reactive protein/albumin ratio was a significant independent predictor of in-hospital mortality (OR 0.812) in elderly patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary intervention.

Study Design

Type

Observational (n=297)

Multicenter

Structured PICO

Does the C-reactive protein/albumin ratio predict in-hospital mortality in elderly patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary intervention?

Population

297 elderly patients diagnosed with non-ST-elevation myocardial infarction who underwent interventional treatment (percutaneous coronary intervention)

Intervention

C-reactive protein/albumin ratio

Outcome

In-hospital mortalityhard clinical

The C-reactive protein/albumin ratio is an inexpensive and easily applicable prognostic marker for predicting in-hospital mortality in elderly NSTEMI patients undergoing PCI.

Main Result

Effect estimate: OR 0.812 (95% CI 0.661-0.998)

p-value: p=0.048

Limitations

Cross-sectional design does not provide prognostic data
Single-center study
Relatively small number of patients
Some patients excluded due to missing clinical data and/or laboratory variables
Presence of multiple comorbidities and vulnerabilities may have affected in-hospital mortality

Abstract

Introduction: Acute myocardial infarction is the most common cardiovascular disease and the cause of significant mortality worldwide. The C-reactive protein/albumin ratio, which measures inflammatory conditions, can be used to predict mortality. In this study, we aimed to investigate the relationship between in-hospital mortality and the C-reactive protein/albumin ratio in patients diagnosed with non-ST-elevation myocardial infarction who underwent interventional treatment at our hospital. Materials and Method: Two hundred and ninety-seven elderly patients were included in the study. The information of the patients was obtained from the hospital database. The C-reactive protein/albumin ratio was calculated for each patient. We used regression analysis to investigate the relationship between the C-reactive protein/albumin ratio and in-hospital mortality. Results: A univariate analysis showed that gender, ejection fraction, white blood cell, glucose, creatinine, systolic and diastolic blood pressure, heart rate, GRACE risk score, and CAR ratio were significant predictors of mortality (Table 2). All parameters were added to a multivariable logistic regression, and multivariable logistic regression analysis showed that the GRACE risk score (OR: 0.956, 95% CI: 0.941–0.971; p<0.001) and the C-reactive protein/albumin ratio (OR: 0.812, 95% CI: 0.661–0.998; p=0.048) were the only significant predictors of mortality. Furthermore, bivariate correlation analysis showed a weak but statistically significant correlation between GRACE risk score and C-reactive protein/albumin ratio (r=0.180, p<0.001). Conclusion: We found a significant relationship between C-reactive protein/albumin and in-hospital mortality. C-reactive protein/albumin ratio can be used in clinical practice because it is inexpensive and easy to apply and has a strong prognostic value for elderly non-ST-elevation myocardial infarction patients. Keywords: Myocardial Infarction; Albumin; Inflammation; Mortality.

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