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.