Long-Term Outcomes After Percutaneous Coronary Intervention According to the High-Sensitivity C-Reactive Protein-to-Albumin Ratio in Patients With Chronic Obstructive Pulmonary Disease in China

Background: Chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) frequently occur together, with systemic inflammation linking these two conditions. Recently, the high-sensitivity C-reactive protein to albumin ratio (hsCAR) has been identified as a composite biomarker of inflammation and nutrition. Thus, this study aimed to examine the prognostic value of hsCAR in patients with COPD-CAD undergoing percutaneous coronary intervention (PCI). Methods: In this cohort study, consecutive patients with COPD-CAD who underwent PCI between 2014 and 2019 were enrolled and categorized into tertiles by hsCAR values. The primary endpoint was major adverse cardiac events (MACEs), including cardiac death, target vessel revascularization (TVR), and nonfatal myocardial infarction (MI). Patients underwent a follow-up for up to 4 years, and the incidence of MACEs was compared between the hsCAR groups using Kaplan-Meier curves and Cox regression analyses. Results: = 0.004). Restricted cubic spline (RCS) analysis showed a linear increase in the risk of MACEs as the absolute value of hsCAR exceeded 0.0446. Subgroup analyses revealed consistent associations across strata, with no significant interactions. Conclusion: Elevated baseline hsCAR is an independent predictor of long-term MACEs in patients with COPD-CAD undergoing PCI. As an inexpensive and readily available biomarker, hsCAR could be used for post-PCI risk stratification to guide targeted secondary prevention in this high-risk population.