An elevated baseline high-sensitivity C-reactive protein to albumin ratio (≥0.079) significantly increased the risk of major adverse cardiac events (HR 3.27) compared to a ratio <0.024 in patients with COPD and CAD undergoing PCI.
Cohort (n=262)
No
Does elevated baseline hsCAR predict long-term MACEs in patients with COPD-CAD undergoing PCI?
Elevated baseline hsCAR is an independent predictor of long-term MACEs in patients with COPD and CAD undergoing PCI, serving as a potential biomarker for risk stratification.
Effect estimate: HR 3.27 (95% CI 1.08-9.86)
Absolute Event Rate: 19.5% vs 5.7%
p-value: p=0.035
Background: Chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) frequently occur together, with systemic inflammation linking these two conditions. Recently, the high-sensitivity C-reactive protein to albumin ratio (hsCAR) has been identified as a composite biomarker of inflammation and nutrition. Thus, this study aimed to examine the prognostic value of hsCAR in patients with COPD–CAD undergoing percutaneous coronary intervention (PCI). Methods: In this cohort study, consecutive patients with COPD–CAD who underwent PCI between 2014 and 2019 were enrolled and categorized into tertiles by hsCAR values. The primary endpoint was major adverse cardiac events (MACEs), including cardiac death, target vessel revascularization (TVR), and nonfatal myocardial infarction (MI). Patients underwent a follow-up for up to 4 years, and the incidence of MACEs was compared between the hsCAR groups using Kaplan–Meier curves and Cox regression analyses. Results: A total of 262 patients were enrolled. Over a median follow-up of approximately 4 years, higher hsCAR levels were associated with an increased incidence of MACEs. The cumulative incidence of MACEs was highest in Group C (hsCAR ≥0.079). The incidence of MACEs was significantly higher in Group C than in Group A (19.5% vs. 5.7%; hazard ratio (HR) = 3.27, 95% confidence interval (CI): 1.08–9.86; p = 0.035). Receiver operating characteristic (ROC) curve analysis confirmed the associated discriminatory ability (area under the curve (AUC) = 0.651; p = 0.004). Restricted cubic spline (RCS) analysis showed a linear increase in the risk of MACEs as the absolute value of hsCAR exceeded 0.0446. Subgroup analyses revealed consistent associations across strata, with no significant interactions. Conclusion: Elevated baseline hsCAR is an independent predictor of long-term MACEs in patients with COPD–CAD undergoing PCI. As an inexpensive and readily available biomarker, hsCAR could be used for post-PCI risk stratification to guide targeted secondary prevention in this high-risk population.
Cao et al. (Wed,) conducted a cohort in Chronic Obstructive Pulmonary Disease and Coronary Artery Disease (n=262). High-sensitivity C-reactive protein to albumin ratio (hsCAR) ≥0.079 vs. hsCAR <0.024 was evaluated on Major adverse cardiac events (MACEs) (HR 3.27, 95% CI 1.08-9.86, p=0.035). An elevated baseline high-sensitivity C-reactive protein to albumin ratio (≥0.079) significantly increased the risk of major adverse cardiac events (HR 3.27) compared to a ratio <0.024 in patients with COPD and CAD undergoing PCI.