a Department of Cardiology , Health Sciences University, Sultan Abdülhamid Han Training and Research Hospital , Istanbul , Turkey.
b Department of Cardiology , Kafkas University Medical Faculty , Kars , Turkey.
Scand Cardiovasc J. 2019 Apr;53(2):83-90. doi: 10.1080/14017431.2019.1590628. Epub 2019 Apr 3.
Although the prognostic efficacy of C-reactive protein (mg/L) and albumin levels (g/L) has been previously associated with poor prognosis in ST elevation myocardial infarction (STEMI), to the best of our knowledge, the prognostic efficacy of C-reactive protein/Albumin ratio (CAR) (mg/g) has not been investigated yet. Thus, this study aimed to investigate the potential efficacy of the CAR in predicting prognosis in STEMI patients.
We conducted a detailed investigation of 2437 patients with first STEMI treated with a primary percutaneous coronary intervention. After evaluation regarding to exclusion criteria, 2243 patients were found to be eligible for analysis. The mean follow-up of the study was 34 ± 15 months.
The median CAR value of the study population was 2.70 (range: 1.44-4.76), and the patients were divided into three tertiles according to their CAR values. Kaplan-Meier survival analysis showed significantly lower in-hospital and long-term survival rates for the patients in a high CAR tertile. In addition, the CAR was found to be an independent predictor of all-cause mortality (Hazards ratio: 1.033, 95% Confidence Interval: 1.007-1.061, p = .033), and the prognostic performance of the CAR was superior to that of C-reactive protein, albumin, and neutrophil to lymphocyte ratio in the receiver operating characteristic curve comparison.
The CAR, a newly introduced inflammation-based risk index, was found to be a potentially useful prognostic tool for predicting a poor prognosis in STEMI patients. However, this finding needs to be validated in the future prospective studies.
尽管 C 反应蛋白（mg/L）和白蛋白水平（g/L）的预后效能先前与 ST 段抬高型心肌梗死（STEMI）的不良预后相关，但据我们所知，C 反应蛋白/白蛋白比值（CAR）（mg/g）的预后效能尚未得到研究。因此，本研究旨在探讨 CAR 预测 STEMI 患者预后的潜在效能。
我们对 2437 例接受直接经皮冠状动脉介入治疗的首次 STEMI 患者进行了详细研究。在评估排除标准后，发现 2243 例患者符合分析条件。本研究的平均随访时间为 34±15 个月。
研究人群的 CAR 值中位数为 2.70（范围：1.44-4.76），根据 CAR 值将患者分为三个三分位组。Kaplan-Meier 生存分析显示，CAR 值较高组的患者住院期间和长期生存率显著降低。此外，CAR 被发现是全因死亡率的独立预测因子（风险比：1.033，95%置信区间：1.007-1.061，p=0.033），并且在接受者操作特征曲线比较中，CAR 的预后性能优于 C 反应蛋白、白蛋白和中性粒细胞与淋巴细胞比值。
CAR，一种新引入的炎症相关风险指数，被发现是预测 STEMI 患者预后不良的一种潜在有用的预后工具。然而，这一发现需要在未来的前瞻性研究中得到验证。
