الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 95 |  |  |
| | | from | 95 | | |
Abstract
A
cute coronary syndrome (ACS) can be divided into subgroups of ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina.
Among patients with acute myocardial infarction (AMI), various pathophysiological events occur due to ischemia and generate an intense inflammatory response.
CAD is mainly caused by atherosclerosis. It is known that inflammation plays a role in the pathogenesis of the initiation and progression of atherosclerosis. C-reactive protein (CRP) levels remain high as a systemic response in cardiovascular diseases based on atherosclerosis. Low serum albumin concentrations have been associated with vascular disease, atherosclerosis, and cardiovascular mortality.
Aim of the study was to assess the correlation between C-reactive protein to albumin ratio (CAR) as a marker of instability of atheromatous plaque and the extent of CAD and the presence of coronary ectasia as a secondary endpoint.
100 patients were divided into:
• group 1: Case group, patients presenting with NSTE-ACS.
• group 2: Control group (age, sex and risk factors matched without any ischemic history, ongoing chest pain or dynamic ECG changes).
The study was conducted on 100 patients, 60% of the control group were males, while in patients group 66% were males, the mean age of control group was 44.6 ± 11.68 years, while mean age of the patients group was 47.96 ± 8.77 years.
The distribution of risk factors in both groups as regards smoking, DM, HTN, showed no statistical significance.
Regarding CRP, the median was 4 mg/L in control group, 13.5 mg/L in patients group, with a highly significant relation (P-value 0.000).
Regarding albumin, the median was 4.09 g/dL in control group, 3.71 g/dL in patients group, with a highly significant relation (P value 0.003).
Regarding CAR, the median was 1 in control group, 3.88 in patients group, with a highly significant relation (P value 0.000).
CRP, albumin and CAR were correlated to syntax score revealing a highly significant correlation with p –value 0.000, 0.004 and 0.000 respectively.
The relation between (CAR, CRP and albumin) and coronary ectasia was not statistically significant.
ROC curve
CRP was found with 100% specificity, 52% sensitivity and AUC 0.822 with cut- off point >10.
Albumin was found with 76% specificity, 54% sensitivity and AUC 0.622 with cut- 0ff <3.8.
CAR was found with 94% specificity, 62% sensitivity and AUC 0.816. with cut-off >2.
CAR is superior to albumin in detecting the atheromatous plaque instability, but not superior to CRP.