Evaluation of the Relationship Between Laboratory Parameters, Severity of Coronary Artery Disease, and Adverse Clinical Outcomes in Patients Undergoing Coronary Angiography

Introduction: Acute coronary syndrome (ACS) continues to represent a major challenge in cardiovascular field despite significant progress in diagnostic and therapeutic interventions. The blood urea nitrogen-to-albumin ratio (BAR), a composite marker easily derived from routine laboratory tests, has recently emerged as a promising indicator in patients with various clinical settings. We aimed to assess the relationship between the BAR and the occurrence of in-hospital major adverse cardiovascular events (MACE) in patients with ACS. Methods: A retrospective analysis was conducted on patients with ACS between December 2022 and June 2025. Patients were categorized into two groups in terms of in-hospital MACE, defined as all-cause mortality, myocardial infarction (MI), or stroke. Clinical variables associated with MACE were analyzed among the comparative groups. To determine independent predictors of in-hospital MACE, both univariate and multivariate logistic regression analyses were conducted. Furthermore, the discriminatory ability of the BAR for predicting in-hospital MACE was evaluated through receiver operating characteristic (ROC) curve analysis. Results: Eight hundred twenty nine patients were included in the study, and 61 (7.4%) experienced in-hospital MACE. Patients who experienced in-hospital MACE had a significantly elevated BAR values compared to those who did not (2.33 vs. 1.58; p<0.001). Multivariate logistic regression analysis revealed that BAR was an independent predictor of in-hospital MACE (odds ratio: 1.312; 95% confidence interval: 1.010-1.703; p=0.042), alongside ST-elevation MI, SYNTAX (SYNergy between PCI with TAXUS™ and Cardiac Surgery) score and lower levels of hemoglobin and serum albumin. ROC curve analysis demonstrated that BAR had a good ability to discriminate between patients who did and did not experience in-hospital MACE, with an area under the curve of 0.784. A BAR cut-off value of 1.72 was identified, offering a sensitivity of 85.2% and a specificity of 61.2% for predicting in-hospital MACE. Conclusion: Our findings suggest that the BAR, a simple, cost-effective biomarker routinely available in clinical practice, is independently associated with in-hospital MACE in ACS patients.