Significance of C-reactive protein to albumin ratio and thrombus burden in acute coronary syndrome

Prince Vijay Raj I
ID
Vignessh Raveekumaran
ID
Department of General Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed to be University), Pondicherry, India
Department of General Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed to be University), Pondicherry, India
Received: 26 March 2025 / Revised: 26 April 2025 / Accepted: 1 May 2025 / Published: 30 September 2025

Abstract

Introduction and aim. Thrombus burden (TB) is a critical factor in the pathogenesis of acute coronary syndrome (ACS) pathogenesis with biomarkers such as C-reactive protein (CRP) and serum albumin that reflect systemic inflammatory and nutritional states. The CRP and albumin ratio (CAR) has emerged as a new composite marker, offering enhanced prognostic value. The aim of this study was to evaluate the association between CAR and TB in patients with ACS and to assess the predictive utility of CAR compared to CRP and albumin individually.

Material and methods. A hospital cross-sectional analytical study was conducted among 93 patients ages 18–60 years with ACS who underwent coronary angiography (CAG). CAR was calculated and its association with TB was analyzed. 

Results. Of the participants, 9.7% had high tuberculosis. CAR, CRP, and albumin were significantly associated with TB (p<0.001). CAR showed the highest correlation (r=0.728) and perfect diagnostic accuracy (AUC=1), outperforming CRP (AUC=0.987) and albumin (AUC=0.030). High TB was significantly associated with the presentation of grade 1 TIMI and ST-elevated myocardial infarction (STEMI) presentation (p<0.05).

Conclusion. CAR is a reliable, accessible and independent biomarker for predicting TB in ACS, and its incorporation into standard clinical protocols could improve early risk stratification, therapeutic decision-making, and patient outcomes. More multicentric study are warranted to validate its broader clinical applicability.

 

Cite 

Raj I. PV, Raveekumaran V. Significance of C-reactive protein to albumin ratio and thrombus burden in acute coronary syndrome. Eur J Clin Exp Med. 2025;23(3):641–648. doi: 10.15584/ejcem.2025.3.21.

 

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