The association between the hsCRP/BMI ratio and cardiovascular prognosis in CAD patients

Abstract Background Some researchers have explored the influence of hsCRP on cardiovascular outcomes stratified by BMI in subjects with known CAD. However, it is unclear whether a novel composite biomarker, the high-sensitivity C-reactive protein (hsCRP)-to-BMI ratio (CBR), is associated with poor prognosis in patients who underwent percutaneous coronary intervention (PCI). Aim We conducted the present study to evaluate the association between the CBR and poor prognosis in CAD patients undergoing percutaneous coronary intervention (PCI). Methods A total of 9,810 patients were prospectively included in the present study. All the participants were classified into 3 groups based on their CBR levels: tertile 1 (CBR ≤ 0.04, n = 3,270), tertile 2 (0.04 < CBR ≤ 0.11, n = 3,270) and tertile 3 (CBR > 0.11, n = 3,270). The primary outcome was defined as major adverse cardiovascular and cerebrovascular events (MACCEs), a composite of all-cause mortality, myocardial infarction (MI), stroke, and target vessel revascularization (TVR). Results During a mean follow-up of 26.7 months, a total of 1022 MACCEs, 122 all-cause deaths, 392 nonfatal MIs, 156 strokes and 461 TVRs were recorded. The outcomes of Kaplan–Meier analysis showed that the incidences of MACCE and MI increased with high tertiles of the CBR (MACCE: 8.8% vs. 10.3% vs. 12.1%, log-rank P < 0.001; myocardial infarction: 3.3% vs. 4.1% vs. 4.7%, log-rank P = 0.018). Cox regression analysis showed that the CBR was independently associated with long-term MACCEs and MI. Conclusion The hsCRP to BMI ratio is independently associated with long-term MACCE and MI in CAD patients undergoing DES implantation.