Relationship between C-reactive protein and uric acid to albumin ratio and coronary collateral circulation in patients with chronic total occlusion

Objective C-reactive protein and uric acid to albumin ratio (CUAR) is a recent inflammatory marker associated with cardiovascular disease. We aim to investigate the relationship between CUAR and coronary collateral circulation (CCC) in patients with stable coronary artery disease and chronic total occlusion (CTO). Methods The patients were divided into two groups; 267 patients with poor CCC formation group and 133 patients with well CCC formation group. CUAR log was calculated using the ‘log10 (CRP × UA/Albumin)’ formula. Results CUAR log levels were significantly higher in patients with poor CCC formation ( P < 0.001). CUAR log levels above 1.45 predicted poor CCC with a higher sensitivity of 70% and specificity of 67% than uric acid to albumin ratio (UAR), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) ( P < 0.001). In the comparison of the AUC values, there was a significant difference between the CUAR log and UAR ( P = 0.047), NLR ( P = 0.001), and PLR ( P < 0.001). In multivariate regression analysis, CUAR log above 1.45 ( P < 0.001) was associated independently with poor CCC occurrence. Conclusion Our results suggested that CUAR log is a more potent and independent marker than other inflammatory markers to predict poor CCC occurrence in CTO patients. It may be useful to identify high-risk patients with poor CCC occurrence.