Combined Prognostic Performance of the CADILLAC Risk Score and C-Reactive Protein/Albumin Ratio in Acute Myocardial Infarction.

BACKGROUND

Acute myocardial infarction (AMI) remains a leading cause of morbidity and mortality, so accurate early risk stratification is essential for predicting adverse events. We investigated whether combining the Creactive protein/albumin ratio (CAR) with the CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications) risk score was associated with an increased risk of 1-year major adverse cardiac events (MACE), and assessed its efficacy in the risk stratification of patients with AMI undergoing primary percutaneous coronary intervention (PCI).

METHODS AND

RESULTS

In total, 554 patients were enrolled. The rate of 1-year MACE was 10.5%. Both the CADILLAC risk category and CAR tertile were independent predictors of 1-year MACE, after adjustment for covariates (hazard ratio [HR] 1.98, 95% confidence interval [CI] 1.34-2.92, P=0.001; HR 1.65, 95% CI 1.14-2.37, P=0.007, respectively). Compared to patients with a low CADILLAC risk score and a low CAR tertile, those with a high CADILLAC risk score and a high CAR tertile had the highest 1-year MACE (adjusted HR 8.13, 95% CI 1.88-35.2, P=0.005). Adding CAR to a model that combined the CADILLAC risk score with the baseline factors significantly improved the prediction of 1-year MACE.

CONCLUSIONS

Combining the CAR with the CADILLAC risk score significantly contributed to predicting 1-year MACE in patients with AMI undergoing primary PCI.