Value of C-reactive Protein/Albumin Ratio for Predicting Ischemia in Myocardial Perfusion Scintigraphy
Süleyman Çağan Efe1, Özlem Özdemir Candan2, Cihan Gündoğan3
1Kartal Koşuyolu Cardiovascular Diseases Training and Research Hospital, Clinic of Cardiology, İstanbul, Turkey
Insights
The C-reactive protein (CRP) to albumin ratio (CAR) can predict ischemia in patients undergoing myocardial perfusion imaging (MPI). Higher CAR levels were associated with a greater likelihood of ischemia, suggesting its utility as a diagnostic marker.
Area of Science:
- Cardiology
- Nuclear Medicine
- Biomarkers
Background:
- Coronary artery disease (CAD) is linked to inflammation.
- The role of the high-sensitivity C-reactive protein (hs-CRP) to albumin ratio (CAR) in myocardial ischemia is not well-established.
- Gated single photon emission tomography (SPECT) myocardial perfusion imaging (MPI) is a key diagnostic tool for ischemia.
Purpose of the Study:
- To investigate the relationship between the CAR and the presence of ischemia detected by gated SPECT MPI.
- To evaluate CAR as a potential predictive biomarker for myocardial ischemia.
Main Methods:
- Retrospective analysis of 126 patients referred for gated SPECT MPI.
- Measurement of serum hs-CRP and albumin levels.
- Classification of patients based on the presence or absence of ischemia on gated SPECT MPI.
Main Results:
- Patients with ischemia showed significantly higher hs-CRP and CAR levels, and lower serum albumin.
- Hypertension and CAR were independent predictors of ischemia in multivariate analysis.
- CAR demonstrated a sensitivity of 76% and specificity of 71% for predicting ischemia, with an optimal cutoff of 0.96.
Conclusions:
- The CAR is a significant predictor of myocardial ischemia.
- CAR may serve as a valuable, readily available biomarker for assessing ischemia risk prior to MPI.
- Further research can explore CAR's role in early detection and management of CAD.
Objectives:
Several studies demonstrate the relationship between coronary artery disease and inflammatory parameters. Nevertheless, there is paucity of data regarding the role of high sensitivity (hs)-C-reactive protein (CRP) to albumin ratio (CAR) in patients with ischemia on gated single photon emission tomography (SPECT) myocardial perfusion imaging (MPI). This study was aimed at demonstrating the relationship between CAR and the occurrence of ischemia on gated SPECT MPI.
Methods:
We retrospectively evaluated 2.048 referred patients for gated SPECT MPI from a cardiology outpatient clinic between October 2017 and June 2019. After applying exclusion criteria and measuring serum CRP and albumin levels, we included 126 patients in the study. We then classified subjects into different groups according to the absence or presence of ischemia on gated SPECT MPI.
Results:
According to laboratory findings, hs-CRP and CAR were significantly higher in the ischemia group, while the serum albumin was significantly lower in ischemia group (p<0.05 for each). The independent predictors of presence of ischemia in multivariate analysis were hypertension and CAR (CAR; odds ratio: 5.720, 95% confidence interval: 2.697-12.133, p<0.001). The optimal value of CAR for presence of ischemia was 0.96 with 76% sensitivity and 71% specificity.
Conclusion:
We found CAR values as a predictor for ischemia before MPI.
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