Hs-CRP to albumin ratio predicts mortality of acute myocardial infarction patients with chronic kidney disease undergoing coronary angiography

Abstract Background The diagnosis and treatment of acute myocardial infarction (AMI) patients with chronic kidney disease (CKD) is still a challenging problem. The high sensitivity C-reactive protein (hs-CRP) to albumin ratio (HCAR) was proved to be a sensitive biomarker in predicting the prognosis of many diseases. The purpose of this study was to investigate the prognostic value of HCAR in postoperative 2-year mortality of AMI patients with CKD undergoing coronary angiography(CAG). Methods A total of 11933 patients underging CAG were collected in this retrospective study. Finally, 466 AMI patients with CKD undergoing CAG were enrolled. HCAR was calculated by dividing hs-CRP by albumin obtained from blood biochemical examination. Patients were divided into two groups according to the HCAR cutoff value in predicting 2-year mortality by Receiver operating characteristic (ROC) curve analysis. The primary endpoint was all-cause mortality at a 2-year follow-up. The Kaplan-Meier method and Cox regression analyses were used to analyze the survival of patients. Results A significant correlation was found between HCAR and NT-proBNP, LVEF, CK-MB, TnI and eGFR (P < 0.05). A cut-off value of 0.24 of HCAR predicted 2-year mortality, with a sensitivity of 66.18% and specificity of 52.21% (ROC area under the curve: 0.60, 95% CI: 0.53–0.68, P < 0.001). A higher HCAR was significantly associated with a higher 2-year mortality rate (45/236 (19%) vs. 23/230 (10%), P = 0.006). The Kaplan-Meier curve showed that the group with a higher HCAR had a worse prognosis (log-rank P < 0.001). HCAR was an independent risk factor for 2-year mortality (OR: 1.779, 95% CI: 1.017–3.112, P = 0.043). Conclusion HCAR might be a potential prognostic indicator of AMI patients with CKD undergoing CAG.