Abstract

Background: Research on the C-reactive protein/albumin ratio (CAR) and the atherogenic index of plasma (AIP) in patients with acute myocardial infarction (AMI), aiming to evaluate CAR and AIP levels in AMI patients and to examine the relationship between CAR, AIP, other factors with the severity of coronary artery lesions as assessed by the Gensini score.

Methods: This cross-sectional study was conducted on 180 patients diagnosed with myocardial infarction at the Cardiovascular Emergency and Intervention Department, Hue Central Hospital, from March 6, 2024, to December 6, 2024.

Results: The mean values of CAR and AIP, and Gensini score were 0.33 ± 0.4 mg/g, 0.17 ± 0.3, and 52.71 ± 35.12, respectively. There was a positive correlation between CAR index and hs-TnT, Gensini and GRACE score (r = 0.182, 0.335, and 0.268, respectively), and a weak positive correlation between AIP and Gensini score (r = 0.149). The optimal cut-off values of CAR and AIP indices for predicting severe coronary artery disease as measured by the Gensini score were 0.274 mg/g (AUC = 0.705, S_e = 56.6%, S_p = 83.3%) and 0.39 (AUC = 0.572, S_e = 28.3%, S_p = 89.2%), respectively. Meanwhile, the combined CAR+AIP index had the best predictive value with AUC = 0.76, S_e = 64.1%, and S_p = 81.1%. The variables CAR, AIP, and systolic blood pressure (SBP) were independently associated with the severity of coronary artery disease as measured by the Gensini score.

Conclusion: A CAR index ≥ 0.274 can predict severe coronary artery disease as measured by the Gensini score, and combined CAR and AIP indices provides higher predictive accuracy (AUC_(CAR+AIP) = 0.76 > AUC_(CAR) = 0,705 > AUC_(AIP) = 0,572). The AIP variable has an independent association with the severity of coronary artery disease.