The C-Reactive Protein to Albumin Ratio Predicts Acute Kidney Injury in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Heart Lung Circ. 2019 Nov;28(11):1638-1645. doi: 10.1016/j.hlc.2018.08.009. Epub 2018 Sep 9.

Abstract

Background: The relationship between acute kidney injury (AKI) and C-reactive protein (CRP) and albumin has been previously demonstrated in patients with ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). However, to our knowledge, CRP to albumin ratio (CAR), a newly introduced inflammation-based risk score, has not yet been studied. In this study, we aimed to investigate the possible relationship between the CAR and AKI.

Method: A total of 815 consecutive STEMI patients treated with pPCI were reviewed.

Results: One hundred ten 110 (13.5%) patients developed AKI in the study population. The subjects were divided into two groups according to AKI development. The in-hospital mortality rate was higher in patients with AKI than those without AKI (15.5% vs. 1.3%; p<0.001). The patients with AKI had significantly higher mean value of CRP and CAR (0.29 [0.16-0.50] vs. 0.55 [0.37-1.05]; p<0.001) and lower mean levels of albumin than those without AKI. Age, diabetes mellitus, haematocrit, left ventricular ejection fraction, hypotension, and CAR (Odds ratio [OR]2.307, 95% confidence interval [CI] 1.397-3.809, p=0.001) were independent predictors of AKI.

Conclusion: The CAR may be a useful inflammation-based risk score to predict AKI development in STEMI patients treated with pPCI.

Keywords: Acute kidney injury; Albumin; C-Reactive protein; C-Reactive protein to albumin ratio; Primary percutaneous coronary intervention; ST elevation myocardial infarction.

MeSH terms

  • Acute Kidney Injury / blood*
  • Acute Kidney Injury / epidemiology
  • Acute Kidney Injury / etiology
  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention*
  • Predictive Value of Tests
  • Preoperative Period
  • Prognosis
  • Retrospective Studies
  • ST Elevation Myocardial Infarction / blood*
  • ST Elevation Myocardial Infarction / complications
  • ST Elevation Myocardial Infarction / surgery
  • Serum Albumin / metabolism*
  • Turkey / epidemiology

Substances

  • Biomarkers
  • Serum Albumin
  • C-Reactive Protein