Süleymanoğlu Muhammed, Burak Cengiz, Gümüşdağ Ayça, Yesin Mahmut, Rencüzoğulları İbrahim, Karabağ Yavuz, Çağdaş Metin, Çap Murat
Department of Cardiology, M.D. Kafkas University Medical Faculty, Kars, Turkey.
Department of Cardiology, M.D. University of Health Sciences, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
Vascular. 2020 Dec;28(6):731-738. doi: 10.1177/1708538120925952. Epub 2020 May 21.
Peripheral arterial disease is associated with increased cardiovascular mortality and morbidity. C-reactive protein and albumin are biomarkers of inflammation and malnutrition that play key roles in the pathophysiological pathways involved in the progression of atherosclerosis and peripheral arterial disease. In this study, we aimed to assess the relationship between C-reactive protein to albumin ratio and the suprapopliteal peripheral arterial disease severity and complexity as assessed by TransAtlantic Inter-Society Consensus-II (TASC-II) classification.
Our study enrolled 224 consecutive patients referred for peripheral angiography with the clinical features of possible peripheral arterial disease at a tertiary care center between January 2016 and September 2019. Level of disease and lesion characteristics were defined with reference to angiographic findings according to the TASC-II classification.
C-reactive protein/albumin ratio levels were significantly higher in TASC-II class C and D than in TASC-II class B patients with a median level of 1.8 to 2.1 vs 1.4, respectively ( = 0.018). In multivariate regression analysis, C-reactive protein to albumin ratio remained an independent predictor of severe peripheral arterial disease. The predictive performance of C-reactive protein to albumin ratio, C-reactive protein, and albumin were compared by Receiver Operating Characteristic curve analysis. C-reactive protein to albumin ratio surpassed C-reactive protein and albumin in predicting peripheral arterial disease severity and complexity. A level of C-reactive protein to albumin ratio > 0.14 predicted a higher grade of suprapopliteal TASC-II class with sensitivity and specificity of 68.2% and 56.0%, respectively.
C-reactive protein to albumin ratio was strongly associated with peripheral arterial disease severity and complexity, as assessed by TASC-II classification. Also, C-reactive protein to albumin ratio was found to be a more accurate marker than C-reactive protein and albumin alone in predicting more severe and complex lesions in patients with peripheral arterial disease.
外周动脉疾病与心血管疾病死亡率和发病率的增加相关。C反应蛋白和白蛋白是炎症和营养不良的生物标志物，在动脉粥样硬化和外周动脉疾病进展所涉及的病理生理途径中起关键作用。在本研究中，我们旨在评估C反应蛋白与白蛋白比值和经跨大西洋跨学会共识II（TASC-II）分类评估的腘上外周动脉疾病严重程度及复杂性之间的关系。
我们的研究纳入了2016年1月至2019年9月期间在一家三级医疗中心因可能患有外周动脉疾病的临床特征而连续接受外周血管造影的224例患者。根据TASC-II分类，参考血管造影结果确定疾病水平和病变特征。
TASC-II C级和D级患者的C反应蛋白/白蛋白比值水平显著高于TASC-II B级患者，中位数水平分别为1.8至2.1与1.4（P = 0.018）。在多变量回归分析中，C反应蛋白与白蛋白比值仍然是严重外周动脉疾病的独立预测因子。通过受试者工作特征曲线分析比较了C反应蛋白与白蛋白比值、C反应蛋白和白蛋白的预测性能。在预测外周动脉疾病严重程度和复杂性方面，C反应蛋白与白蛋白比值超过了C反应蛋白和白蛋白。C反应蛋白与白蛋白比值>0.14预测更高等级的腘上TASC-II分类，敏感性和特异性分别为68.2%和56.0%。
经TASC-II分类评估，C反应蛋白与白蛋白比值与外周动脉疾病严重程度及复杂性密切相关。此外，在预测外周动脉疾病患者更严重和复杂的病变方面，发现C反应蛋白与白蛋白比值比单独的C反应蛋白和白蛋白是更准确的标志物。
