Relationship between C-reactive protein-to-albumin ratio and the extent of coronary artery disease in patients with non-ST-elevated myocardial infarction

Background This study aimed to investigate the predictive value of the newly defined C-reactive protein (CRP)-toalbumin ratio (CAR) in determining the extent and severity of coronary artery disease (CAD) in comparison with the other inflammatory markers such as neutrophil-tolymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), in patients with non-ST-elevated myocardial infarction (NSTEMI). Patients and methods This study is retrospectively designed and includes 205 patients with NSTEMI with a mean age of 56.6 +/- 11.4 years. The study cohort was subdivided into two groups according to Synergy Between Percutaneous Coronary Intervention with Taxus and cardiac surgery score (SS) as low (<23) and intermediate-high (>= 23). Complete blood counts, serum CRP, and serum albumin were obtained at admission. The CAR, NLR, and PLR values of all patients were calculated. Then, we evaluated the relationship of CAR, NLR, and PLR with the CAD extent and severity. Results CAR and NLR were moderately correlated with SS (r = 0.517, P < 0.001; r = 0.222, P = 0.001, respectively), whereas PLR showed weak correlation with SS (r = 0.191, P = 0.006). According to multivariate analysis models, CAR, NLR, and left ventricular ejection fraction were found to be independent predictors of CAD severity (P < 0.05). The area under the curve (AUC) for CAR (AUC: 0.829; 95% confidence interval: 0.770-0.878) was significantly greater than the AUC of NLR (AUC: 0.657; 95% confidence interval: 0.588-0.722), with P value of 0.002. A CAR more than 17 predicted an intermediate-high SS with 86% sensitivity and 76% specificity. Conclusion Novel inflammatory marker CAR can be used as a reliable marker in prediction of CAD severity in patients with NSTEMI.