Association of C-reactive protein to albumin ratio with angiographic severity of coronary artery disease in non-ST elevation myocardial infarction patients

Background: The C-reactive protein to albumin ratio (CAR) is a potential biomarker for inflammation and nutrition in cardiovascular diseases. Elevated CRP indicates inflammation, while albumin reflects nutritional status, offering insights into the pathophysiology and severity of coronary artery disease (CAD). This study aimed to investigate the relationship between the CRP to Albumin ratio (CAR) and the angiographic severity of CAD in non-ST elevation myocardial infarction (NSTEMI) patients. Methods: This study was conducted at the National Institute of Cardiovascular Diseases (NICVD) Dhaka, Bangladesh from May 2018 to April 2019, involving 200 patients with NSTEMI undergoing coronary angiography (CAG). The patients were divided equally into two groups based on the CAR: Group I had a CAR of >11, and Group II had a CAR of ≤11. Data were analyzed by the SPSS version 26.0 program. Results: The mean SYNTAX score (SS) was higher in Group I than in Group II (p<0.001). CAR>11 independently predicted intermediate-high SS (p<0.001). CAR and SS correlated significantly (p<0.001). The ROC curve showed an AUC of 0.878 for CAR (Sensitivity: 77.3%, Specificity: 70.0%). Conclusions: CAR is significantly associated with the severity of CAD, as measured by the SYNTAX score, in patients with NSTEMI. CAR can be used as a reliable marker in the prediction of CAD severity in patients with NSTEMI.