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Serum Albumin-to-Creatinine Ratio: A Novel Predictor of Pulmonary Infection in Patients with ST-Segment Elevation
Siyu Kong1,2, Shijie Yu3, Weibin He1,2
1Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University.
Insights
A low serum albumin-to-creatinine ratio (sACR) is linked to higher risks of pulmonary infection and major adverse cardiovascular events (MACE) in ST-elevation myocardial infarction (STEMI) patients undergoing PCI. This ratio also predicts long-term mortality, highlighting its prognostic value.
Area of Science:
- Cardiology
- Biochemistry
- Pulmonology
Background:
- ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI) face risks of adverse outcomes.
- Low serum albumin-to-creatinine ratio (sACR) is a known risk factor for poor outcomes in STEMI patients.
- The association between sACR and pulmonary infections in STEMI patients undergoing PCI is not well-established.
Purpose of the Study:
- To investigate the relationship between sACR and pulmonary infection during hospitalization in STEMI patients undergoing PCI.
- To evaluate sACR as a predictor of in-hospital major adverse cardiovascular events (MACE) and long-term all-cause mortality.
Main Methods:
- A cohort of 4,507 STEMI patients undergoing PCI was analyzed.
- Patients were stratified into three groups based on sACR tertiles.
- Outcomes included pulmonary infection, in-hospital MACE, and long-term all-cause mortality.
Main Results:
- A low sACR showed a significant, non-linear association with an increased risk of pulmonary infection (P=0.039).
- sACR demonstrated good predictive value for both pulmonary infection (AUC=0.73) and in-hospital MACE (AUC=0.72).
- Higher sACR tertiles correlated with better survival rates, and lower sACR independently predicted long-term mortality (HR=0.96).
Conclusions:
- Low sACR is significantly associated with an increased risk of pulmonary infection and MACE in STEMI patients undergoing PCI.
- sACR serves as a valuable prognostic marker for hospitalization outcomes and long-term mortality in this population.
- These findings underscore the importance of monitoring sACR in STEMI patients post-PCI.
Aim:
In patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI), a low serum albumin-to-creatinine ratio (sACR) is associated with elevated risk of poor short- and long-term outcomes. However, the relationship between sACR and pulmonary infection during hospitalization in patients with STEMI undergoing PCI remains unclear.
Methods:
A total of 4,507 patients with STEMI undergoing PCI were enrolled and divided into three groups according to sACR tertile. The primary outcome was pulmonary infection during hospitalization, and the secondary outcome was in-hospital major adverse cardiovascular events (MACE) including stroke, in-hospital mortality, target vessel revascularization, recurrent myocardial infarction, and all-cause mortality during follow-up.
Results:
Overall, 522 (11.6%) patients developed pulmonary infections, and 223 (4.9%) patients developed in-hospital MACE. Cubic spline models indicated a non-linear, L-shaped relationship between sACR and pulmonary infection (P=0.039). Receiver operating characteristic curve analysis indicated that sACR had good predictive value for both pulmonary infection (area under the ROC curve [AUC]=0.73, 95% CI=0.70-0.75, P＜0.001) and in-hospital MACE (AUC=0.72, 95% CI=0.69-0.76, P＜0.001). Kaplan-Meier survival analysis indicated that higher sACR tertiles were associated with a greater cumulative survival rate (P＜0.001). Cox regression analysis identified lower sACR as an independent predictor of long-term all-cause mortality (hazard ratio [HR]=0.96, 95% CI=0.95-0.98, P＜0.001).
Conclusions:
A low sACR was significantly associated with elevated risk of pulmonary infection and MACE during hospitalization, as well as all-cause mortality during follow-up among patients with STEMI undergoing PCI. These findings highlighted sACR as an important prognostic marker in this patient population.
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