C-Reactive Protein to Albumin Ratio as a Marker of Atheromatous Plaque Instability in NSTE-ACS

Abstract Background Acute coronary syndrome (ACS) can be divided into subgroups of ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina. ACS carries significant morbidity and mortality and the prompt diagnosis, and appropriate treatment is essential. The current 2018 clinical definition of myocardial infarction (MI) requires the confirmation of the myocardial ischemic injury with abnormal cardiac biomarkers. Objective to assess correlation between C-reactive protein to albumin ratio (CAR) as a marker of instability of atheromatous plaque and the extent of CAD and the presence of coronary ectasia as a secondary endpoint. Methods This is a Case control Study that included one hundred patients who presented to Ain Shams University hospitals. Results CAR was higher in patients group than in control group with a highly significant relation with p – value 0.000. CAR was correlated to syntax score revealing a highly significant correlation with p –value 0.000. There was no statistical significance between CAR and coronary ectasia. CAR is superior to albumin in detecting the patient group, but not superior to CRP. Conclusion CAR was found higher in the patient group than in the control group suggesting its potential use as a marker of atheromatous plaque instability. CAR can serve as a marker of Coronary artery severity as it was observed that patients with higher SS also had higher CAR levels.