Aksoy Fatih, Uysal Dinçer, Ibrişim Erdogan
. Associate Professor from the Department of Cardiology, Suleyman Demirel University, Medical School, Isparta, Turkey.
. Associate Professor from the Department of Cardiovascular Surgery, Suleyman Demirel University, Medical School, Isparta, Turkey.
Rev Assoc Med Bras (1992). 2020 Aug;66(8):1049-1056. doi: 10.1590/1806-9282.66.8.1049.
This study aimed to investigate the predictive value of the newly defined C-Reactive Protein (CRP)/Albumin Ratio (CAR) in determining the development of atrial fibrillation (AF) in comparison with other inflammatory markers, such as Neutrophil/Lymphocyte (N/L) Ratio and Platelet/Lymphocyte (P/L) Ratio, in patients undergoing Coronary Artery Bypass Grafting (CABG) surgery.
The population of this observational study consisted of 415 patients undergoing CABG. The study cohort was subdivided into two groups based on the development of AF. Complete blood counts, serum CRP, and serum albumin levels were evaluated before the CABG. The CAR, N/L, and P/L ratios of all the patients were calculated. Predictors of postoperative AF were determined by multiple logistic regression analysis (MLRA).
During follow-up, 136 patients (32.8%) developed postoperative AF. With MLRA, independent risk factors for postoperative AF were determined as follows: fasting glucose level (OR: 1.01; 95 % CI: 1.00-1.01, P <0.001), age (OR: 1.12; 95 % CI: 1.07-1.17, P <0.001), left ventricle ejection fraction (OR: 0.90; 95 % CI: 0.87-0.94, P <0.001), male gender (OR: 3.32; 95 % CI: 1.39-7.90, P = 0.007), 24-hour drainage amount (OR: 1.004; 95 % CI: 1.002-1.005, P <0.001), and CAR (OR: 1.82; 95 % CI: 1.53-2.16, P <0.001). Receiver Operating Characteristic curve analysis showed that CAR (C-statistic: 0.75; 95% CI: 0.71-0.79, p< 0.001) was a significant predictor of AF.
Novel inflammatory marker CAR can be used as a reliable marker to predict the development of AF following CABG.
本研究旨在探讨新定义的C反应蛋白（CRP）/白蛋白比值（CAR）与其他炎症标志物（如中性粒细胞/淋巴细胞比值（N/L）和血小板/淋巴细胞比值（P/L））相比，在冠状动脉旁路移植术（CABG）患者中预测房颤（AF）发生发展的价值。
本观察性研究纳入了415例行CABG手术的患者。根据AF的发生情况将研究队列分为两组。在CABG手术前评估全血细胞计数、血清CRP和血清白蛋白水平。计算所有患者的CAR、N/L和P/L比值。通过多因素逻辑回归分析（MLRA）确定术后AF的预测因素。
随访期间，136例患者（32.8%）发生了术后AF。通过MLRA确定术后AF的独立危险因素如下：空腹血糖水平（OR：1.01；95%CI：1.00 - 1.01，P <0.001）、年龄（OR：1.12；95%CI：1.07 - 1.17，P <0.001）、左心室射血分数（OR：0.90；95%CI：0.87 - 0.94，P <0.001）、男性（OR：3.32；95%CI：1.39 - 7.90，P = 0.007）、24小时引流量（OR：1.004；95%CI：1.002 - 1.005，P <0.001）和CAR（OR：1.82；95%CI：1.53 - 2.16，P <0.001）。受试者工作特征曲线分析显示，CAR（C统计量：0.75；95%CI：0.71 - 0.79，p <0.001）是AF的显著预测指标。
新型炎症标志物CAR可作为预测CABG术后AF发生发展的可靠指标。
