Relationship Between Lactate Albumin Ratio and Mortality in Patients with Ischemia and Non-Obstructive Coronary Artery Disease (INOCA)

Aim: Ischemia with non-obstructive coronary artery disease (INOCA) is when there is myocardial ischemia without occlusive coronary artery disease. Over time, this could result in a reduced quality of life, frequent hospital visits, and a higher risk of cardiovascular-related deaths. Diagnosis, management, and prognosis of INOCA pose challenges. Lactate-albumin ratio (LAR) has been associated with mortality from many cardiovascular diseases. The study examined the link between LAR and mortality in patients with INOCA. Material and Method: The study began by analyzing the data of 987 patients who visited our center between 2017 and 2023 and were diagnosed with myocardial perfusion imaging with single photon emission computed tomography (MPI-SPECT) showing ischemia. We included 279 patients in the study after applying the exclusion criteria. Medical histories, laboratory parameters, and patient death information were recorded. Results: The mean follow-up time was 205±47 days. Mortality occurred in 5% of patients (14 patients). Patients were divided into two groups: mortality and non-mortality. While LAR was 0.65 ± 0.26 in the non-mortality group, it was 1.05 ± 0.32 in the mortality group, demonstrating a statistically meaningful dissimilarity between the two groups (p=0.017). Cox regression analysis was conducted to determine mortality predictors. Age and LAR emerged as independent predictors of mortality in INOCA patients (p=0.03 and p=0.005, respectively). We utilized Receiver Operating Characteristic (ROC) analysis to consider the effectiveness of LAR in predicting mortality. As a result of the examination, the area under the curve (AUC) was determined as 0.689 (0.519-858), the cut-off was 0.656, the sensitivity was 57.1%, and the specificity was 52.8% (p=0.017) Conclusion: Our study found that LAR performs as an independent predictor of mortality in patients with INOCA.