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: A total of 262 patients were enrolled. Over a median follow-up of approximately 4 years, higher hsCAR levels were associated with an increased incidence of MACEs. The cumulative incidence of MACEs was highest in Group C (hsCAR ≥0.079). The incidence of MACEs was significantly higher in Group C than in Group A (19.5% vs. 5.7%; hazard ratio (HR) = 3.27, 95% confidence interval (CI): 1.08-9.86; 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.