Association of the C-reactive protein/albumin ratio with major adverse cardiovascular events following elective PCI in elderly patients with unstable angina pectoris

Background: This study aimed to investigate the predictive value of C-reactive protein (CRP)/albumin (ALB) ratio (CAR) for the occurrence of major adverse cardiovascular events (MACE) following elective percutaneous coronary intervention (PCI) in elderly patients with unstable angina (UA). Methods: A retrospective analysis was conducted on 307 patients with UA who underwent elective PCI between January 2021 and September 2023. The patients were followed up for one year post-operation and categorized into two groups: the MACE group (62 cases) and non-MACE group (245 cases) based on the occurrence of adverse cardiovascular events. Multivariate logistic regression analysis was used to screen the factors influencing the occurrence of MACE, and receiver operating characteristic (ROC) curves were used to analyze the predictive value of CRP, ALB and CAR for MACE. Results: Compared to the non-MACE group, patients in the MACE group exhibited significantly lower albumin (ALB) levels (p < 0.05) and significantly higher CRP and CAR values (p < 0.05). ROC curve showed that the area under the curve (AUC) for CRP and ALB in predicting MACE was 0.869 and 0.792, respectively with a sensitivity of 74.19% and 70.97%, and a specificity of 86.53% and 76.73%. The AUC of CAR for predicting MACE was 0.918, significantly higher than that of CRP (Z = 3.820, p < 0.001) and ALB (Z = 3.490, p < 0.001), with a sensitivity and specificity of 87.10% and 87.76%, respectively. Multifactorial logistic regression analysis revealed smoking history, multiple coronary lesions, age, neutrophil-to-lymphocyte ratio (NLR) and elevated CAR as significant risk factors for MACE after elective PCI in elderly UA patients (p < 0.05). Conclusions: CAR is a strong predictor of MACE following elective PCI in elderly patients with UA, and elevated CAR values are associated with an increased likelihood of MACE.

C-reactive protein; Albumin; Unstable angina; Percutaneous coronary intervention; Adverse cardiovascular events

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