Diabetology & Metabolic Syndrome (Feb 2023)

A novel inflammatory biomarker, high-sensitivity C-reactive protein-to-albumin ratio, is associated with 5-year outcomes in patients with type 2 diabetes who undergo percutaneous coronary intervention

  • Jiawen Li,
  • Pei Zhu,
  • Yulong Li,
  • Kailun Yan,
  • Xiaofang Tang,
  • Jingjing Xu,
  • Weixian Yang,
  • Shubin Qiao,
  • Yuejin Yang,
  • Runlin Gao,
  • Bo Xu,
  • Jinqing Yuan,
  • Xueyan Zhao

DOI
https://doi.org/10.1186/s13098-022-00977-9
Journal volume & issue
Vol. 15, no. 1
pp. 1 – 10

Abstract

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Abstract Background Patients with coronary artery disease (CAD) combined with diabetes have a higher risk of cardiovascular events, and high-sensitivity C-reactive protein (hs-CRP)-to-albumin ratio (CAR) is a novel inflammatory biomarker. However, whether the CAR can identify high-risk patients with CAD and type 2 diabetes (T2DM) remains unclear. Methods The present study was based on a prospective and observational cohort with 10,724 individuals who undergo percutaneous coronary intervention (PCI) in Fu Wai Hospital throughout the year 2013 consecutively enrolled. The primary endpoint was all-cause mortality. The secondary endpoint was cardiac mortality. CAR was calculated with the formula: hs-CRP (mg/L)/albumin (g/L). According to the optimal cut-off value of CAR for all-cause mortality, patients were divided into higher CAR (CAR-H) and lower CAR (CAR-L) groups. Results A total of 2755 patients with T2DM who underwent PCI and received dual antiplatelet therapy were finally enrolled. During a follow-up of 5 years (interquartile range: 5.0–5.1 years), 126 (4.6%) all-cause mortalities and 74 (2.7%) cardiac mortalities were recorded. In the multivariable Cox model, CAR-H was associated with a higher risk of all-cause mortality (hazard ratio [HR]: 1.634, 95% confidence interval [CI] 1.121–2.380, p = 0.011) and cardiac mortality (HR: 1.733, 95% CI 1.059–2.835, p = 0.029) compared with CAR-L. When comparing the predictive value, CAR was superior to hs-CRP for all-cause mortality (area under the curve [AUC] 0.588 vs. 0.580, p = 0.002) and cardiac mortality (AUC 0.602 vs. 0.593, p = 0.004). Conclusion In this real-world cohort study, a higher level of CAR was associated with worse 5-year outcomes among diabetic patients with PCI.

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