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September 10, 2026Circulation Reports0 citationsOpen Access

Combined Prognostic Performance of the CADILLAC Risk Score and C-Reactive Protein/Albumin Ratio in Acute Myocardial Infarction

MOMitsutoshi OguriSMSoichiro MaedaSYSatoya Yoshida

Key Result

Compared to patients with a low CADILLAC risk score and a low C-reactive protein/albumin ratio (CAR), those with a high CADILLAC risk score and a high CAR had a significantly increased risk of 1-year major adverse cardiac events (adjusted HR 8.13).

Key Points

  • To investigate whether combining the C-reactive protein/albumin ratio with the CADILLAC risk score improves prediction of one-year major adverse cardiac events in acute myocardial infarction.
  • Evaluated patients presenting with acute myocardial infarction who underwent primary percutaneous coronary intervention.
  • Combined the C-reactive protein/albumin ratio with the CADILLAC risk score to assess prognostic performance for adverse events.
  • The combination of the C-reactive protein/albumin ratio and CADILLAC risk score was evaluated for predicting one-year major adverse cardiac events, though specific numerical risk estimates and effect sizes are not reported in the provided text.
  • Prognostic efficacy was examined to establish enhanced early risk stratification in patients undergoing primary angioplasty.

Study Design

Type

Cohort (n=554)

Multicenter

No

Structured PICO

Does combining the C-reactive protein/albumin ratio (CAR) with the CADILLAC risk score improve the prediction of 1-year MACE in patients with acute myocardial infarction undergoing primary PCI?

P
Population
554 patients (median age 72 years, 22.9% female) with acute myocardial infarction undergoing primary percutaneous coronary intervention, excluding those with cardiogenic shock, followed for 1 year.
E
Exposure
Risk stratification using the combination of C-reactive protein/albumin ratio (CAR) and the CADILLAC risk score
O
Outcome
1-year major adverse cardiac events (MACE), defined as a composite of all-cause death, nonfatal MI, clinically driven target lesion revascularization, hospitalization for heart failure requiring intravenous treatment, and stent thrombosiscomposite

Combining the C-reactive protein/albumin ratio with the CADILLAC risk score significantly improves the prediction of 1-year major adverse cardiac events in patients with acute myocardial infarction undergoing primary PCI.

Main Result

Hazard Ratio: 8.13 (95% CI 1.88–35.2)

p-value: p=0.005

Limitations

  • Single-center retrospective study design
  • Prehospital conditions, including concomitant infectious diseases, were not evaluated
  • Exclusion of patients with cardiogenic shock limits generalizability to hemodynamically unstable patients
  • Lack of combined analysis with established scores other than the CADILLAC risk score
  • Missing data on initial CK, CK-MB, hs-cTn levels, and culprit lesion location
  • Low incidence of clinically driven target lesion revascularization and nonfatal myocardial reinfarction limited statistical power for these endpoints
  • Subgroup findings regarding STEMI vs non-STEMI are exploratory due to lack of statistically significant interaction

Abstract

Background: Acute myocardial infarction (AMI) remains a leading cause of morbidity and mortality, so accurate early risk stratification is essential for predicting adverse events. We investigated whether combining the Creactive protein/albumin ratio (CAR) with the CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications) risk score was associated with an increased risk of 1-year major adverse cardiac events (MACE), and assessed its efficacy in the risk stratification of patients with AMI undergoing primary percutaneous coronary intervention (PCI).

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Cite This Study

Oguri et al. (2026) conducted a cohort in Acute myocardial infarction (AMI) (n=554). High CADILLAC risk score and high C-reactive protein/albumin ratio (CAR) vs. Low CADILLAC risk score and low CAR was evaluated on 1-year major adverse cardiac events (MACE) (HR 8.13, 95% CI 1.88-35.2, p=0.005). Compared to patients with a low CADILLAC risk score and a low C-reactive protein/albumin ratio (CAR), those with a high CADILLAC risk score and a high CAR had a significantly increased risk of 1-year major adverse cardiac events (adjusted HR 8.13).

synapsesocial.com/papers/6aa27a7f58559d80afc7310bhttps://doi.org/10.1253/circrep.cr-26-0231
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