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CRP-to-albumin ratio predicts acute kidney injury in STEMI patients

28 Oct 2019

The C-reactive protein (CRP)-to-albumin ratio (CAR) appears to be linked to the development of acute kidney injury (AKI) in patients with ST elevation myocardial infarction (STEMI), a recent study has found.

Researchers retrospectively assessed 815 consecutive STEMI patients (mean age, 57±12 years; 18.0 percent male) who were undergoing treatment with primary percutaneous coronary intervention (pPCI). Only 13.5 percent (n=110) of the participants had AKI.

CAR (0.29 vs 0.55; p<0.001) was significantly higher in those with AKI, and so were CRP, peak creatinine kinase myocardial band and total ischaemic time (p<0.001). On the other hand, haematocrit level, estimated glomerular filtration rate and left ventricular ejection fraction values were all significantly lower in AKI patients (p<0.001 for all).

Participants were categorized into tertiles of CAR values: <0.209 (n=271), 0.209–0.457 (n=272) and >0.457 (n=272). The incidence rate of AKI increased along with CAR tertiles (4.4 percent vs 10.7 percent vs 25.4 percent, respectively). Each pairwise comparison was statistically significant (p<0.001).

Multivariate regression analysis further confirmed that CAR was a significant predictor of AKI development (odds ratio [OR], 2.307, 95 percent CI, 1.397–3.809; p0.001). Other significant risk factors included diabetes mellitus (OR, 1.708, 1.053–2.769; p=0.030), haematocrit (OR, 0.957, 0.928–0.986; p=0.004) and hypertension (OR, 3.087, 1.624–5.871; p≤0.001).

Excluding patients with cardiogenic shock did not attenuate the relationship between CAR and AKI risk (OR, 3.076, 1.679–5.636).

Moreover, CAR also showed a significantly higher area under the receiver operating characteristic curve than CRP (0.724 vs 0.705; p<0.001) and albumin level (0.724 vs 0.679; p<0.001).

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Most Read Articles
Pearl Toh, 31 Dec 2019
Adding the neuraminidase inhibitor oseltamivir to usual care speeds up recovery from influenza-like illness by a day compared with usual care alone, with even greater benefits seen in older, sicker patients with comorbidities, according to the ALIC4E study.
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At a Menarini-sponsored symposium held during the Asian Pacific Society Congress, renowned cardiologist Prof John Camm provided the latest evidence for chronic stable angina with or without concomitant diseases, with a special focus on the antianginal agent ranolazine and combination therapies. The event was chaired and moderated by Dr Dante Morales from the University of the Philippines College of Medicine.
6 days ago
Testosterone treatment may slightly improve sexual functioning and quality of life in men without underlying organic causes of hypogonadism, but it offers little to no benefit for other common symptoms of ageing, according to a study. In addition, long-term efficacy and safety of this therapy remain unknown.
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