Relationship Between Hs-CRP /ALB Ratio And Degree Of Coronary Stenosis And Recent Prognosis

Purpose:C-reactive protein(CRP)is a common inflammatory index,which is of great significance for the identification of infection and various connective tissue diseases,judgment of the severity or activity of the disease.Due to the increased sensitivity of the assay,hypersensitivity C-response protein(hs-CRP)has unique guiding significance for the diagnosis and treatment of cardiovascular diseases.It has been reported in the literature that C-reactive protein / albumin ratio(CRP / ALB)can be used to evaluate the condition and prognosis of emergency patients.This study intends to explore the relationship between the hypersensitive C-reactive protein / albumin ratio(hs-CRP /ALB)and the severity of coronary artery stenosis and recent prognosis in patients with acute coronary syndrome(ACS).Method:A total of 186 patients selected from May 2019 to September 2019 in Subei people's Hospital of Jiang Su Province and received coronary angiography were selected.The venous blood was drawn early in the morning after admission and strictly controlled under PCI(Percutaneous Coronary Intervention,Preoperative coronary artery interventional therapy)Before the operation,record the patient's general information(age,gender,height,weight,systolic blood pressure at admission,diastolic blood pressure,heart rate),previous medical history,laboratory indicators(ALB,hs-CRP,blood lipids,blood sugar,markers of myocardial injury,NTpro-BNP,glycated hemoglobin,etc.),coronary angiography,cardiac function classification,the occurrence of major adverse cardiovascular events(MACE)in the hospital and the other related data.Taking the 60 th day after discharge as the cut-off point,the occurrence of MACE was recorded through outpatient and telephone follow-up.Based on the results of coronary angiography,the patient's Gensini score was calculated.The patients were divided into ACS group(122 cases)and control group(64 cases),including 68 cases of unstable angina(UA)and 54 cases of acute myocardial infarction(AMI).According to the hs-CRP / ALB score,the ACS group was divided into high hs-CRP/ALB group(61cases)and low hs-CRP/ALB group(61 cases).SPSS 26.0 software was used to analyze and compare the statistical differences of the research objects between the groups.Results:1.The ACS group(122 cases)had a higher age,heart rate at admission,the number of patients with hyperlipidemia,the number of smoking patients,troponin I,NTpro-BNP,hs-CRP,and hs-CRP/ALB than the control group(64 cases),The ejection fraction and ALB level were lower than the control group,the difference was statistically significant(P <0.05).2.The statistical comparison of hs-CRP,ALB,hs-CRP / ALB in the control group,UA group,and AMI group found that with the increase of the severity of the disease,ALB gradually decreased,hs-CRP,hs-CRP / ALB gradually rise.The comparison between the two groups revealed that there were significant differences in hs-CRP,ALB,and hs-CRP / ALB between the two groups(P <0.05).3.The age of patients,heart rate at admission,the number of hyperlipidemia patients,the number of smoking patients,troponin I,NTpro-BNP,ejection fraction,hs-CRP,ALB,hs-CRP/ALB were analyzed by Spearman correlation with ACS.There is a correlation between the items(P <0.05).4.The heart rate,troponin I,NT-pro BNP,Gensini score,the incidence of MACE in hospital and within 60 days after discharge in the high hs-CRP/ALB group were higher than those in the low hs-CRP/ALB group,and the ejection fraction and ALB levels were lower than that in the low hs-CRP/ALB group.It is statistically significant(P <0.05).5.Using Spearman correlation analysis,the results showed that hs-CRP/ALB,hs-CRP,and ALB in ACS patients were correlated with Gensini score,which was statistically significant(P <0.05).and the correlation between hs-CRP/ALB and ACS is the most significant(r = 0.693).6.Comparing hs-CRP/ALB,hs-CRP,ALB and MACE occurred 60 days after discharge of coronary heart disease patients.Using the receiver operating characteristic curve(ROC curve)method,the area under the hs-CRP/ALB curve was calculated to be0.815(95% CI : 0.723-0.907,P <0.001),the area under the hs-CRP curve is 0.792(95%CI: 0.691-0.893,P = 0.001),the area under the ALB curve is 0.235(95% CI:0.089-0.382,P = 0.002).Among them,the area under the curve of hs-CRP/ALB is the largest,and the difference between the area under the curve of hs-CRP is statistically significant(P = 0.0237),and has the highest predictive value for the recent prognosis of ACS patients.Combined with the curve coordinates,the hs-CRP/ALB Youden Index is calculated.When the hs-CRP/ALB value is 0.0762,the maximum Youden Index is0.565.At this time,the sensitivity is 0.909 and the specificity is 0.642.Calculate the Youden index of hs-CRP.When the hs-CRP value is 4.615,the maximum value of the Youden index is 0.525.At this time,the sensitivity is 0.846 and the specificity is 0.679.Conclusions:ALB,hs-CRP,hs-CRP/ALB are all related to the incidence of ACS.In ACS patients,hs-CRP/ALB is closely related to the degree of coronary stenosis.hs-CRP/ALB can be used to predict the patient's recent prognosis,and the predictive value is better than hs-CRP or ALB alone.