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Submitted: 18 May 2020
Revision: 15 Jul 2020
Accepted: 03 Aug 2020
ePublished: 16 Aug 2020
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J Cardiovasc Thorac Res. 2020;12(3): 179-184.
doi: 10.34172/jcvtr.2020.31
  Abstract View: 91
  PDF Download: 112

Original Article

The association of preprocedural C-reactive protein/albumin ratio with in-stent restenosis in patients undergoing iliac artery stenting

Ali Nazmi Çalık 1* ORCID logo, Duygu İnan 1 ORCID logo, Mehmet Baran Karataş 1 ORCID logo, Evliya Akdeniz 1 ORCID logo, Duygu Genç 1 ORCID logo, Yiğit Çanga 1 ORCID logo, Tufan Çınar 2 ORCID logo, Ayşe Emre 1 ORCID logo

1 University of Health Sciences, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
2 University of Health Sciences, Sultan Abdülhamid Han Training and Research Hospital, Istanbul, Turkey
*Corresponding Author: Ali Nazmi Çalık, Email: calik_nazmi@hotmail.com

Abstract

Introduction: In-stent restenosis (ISR) still constitutes a major problem after percutaneous vascular interventions and the inflammation has a pivotal role in the pathogenesis of such event. The C-reactive protein/albumin ratio (CAR) is a newly identified inflammatory biomarker, and it may be used as an indicator to predict ISR in subjects with coronary artery stenting. In light of these data, our main objective was to investigate the relationship between the preprocedural CAR and ISR in patients undergoing successful iliac artery stent implantation.
Methods:
In total, 138 consecutive patients who had successful iliac artery stent implantation in a tertiary heart center between 2015 and 2018 were enrolled in the study. The study population was categorized into two groups; patients with ISR and those without ISR during follow-up. The CAR was determined by dividing CRP by serum albumin.
Results: In the multivariable regression analysis; the CAR (HR: 2.66, 95% CI: 1.66-4.25, P < 0.01), stent length (HR: 1.01, 95% CI: 0.99-1.02, P = 0.04), and HbA1c levels (HR: 1.22, 95% CI: 0.99-1.51, P = 0.04) were independently related with ISR. A receiver operating curve analysis displayed that the CAR value of >0.29 predicted ISR with sensitivity of 97.5% and specificity of 88.8% (AUC 0.94, P < 0.01).
Conclusion: Our findings provide evidence that the CAR may be an applicable inflammatory biomarker in predicting ISR in subjects undergoing iliac artery stenting for the treatment of peripheral artery disease (PAD). Also, the stent length and poor glycemic control were found to be associated with ISR.
Keywords: C-Reactive Protein, Albumin, Ratio, In-stent Restenosis, Iliac Artery Disease
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