Analysis of the Prognostic Value of C-Reactive Protein to Hemoglobin Ratio in Patients with Stable Coronary Artery Disease after Percutaneous Coronary Intervention: A Secondary Analysis of a Retrospective Cohort Study

Abstract Objective: To study and analyze the clinical value of the C-reactive protein (CRP) to hemoglobin (Hb) ratio (CHR) in predicting the prognosis of patients with stable coronary artery disease (SCAD) after percutaneous coronary intervention (PCI). Methods: This retrospective cohort study utilized patient data collected and uploaded by the Sho Suzuki team from Shinonoi General Hospital. General clinical data, hemoglobin, C-reactive protein, albumin, blood lipids, glycated hemoglobin, serum creatinine, and left ventricular ejection fraction (LVEF) by echocardiography were studied. The endpoint was the occurrence of major adverse cardiac events (MACE), including all-cause death, non-fatal myocardial infarction, and non-fatal stroke. The optimal cutoff value of 0.028 was selected based on the receiver operating characteristic (ROC) curve. Patients were divided into a low CHR group (<0.028, n=161) and a high CHR group (≥0.028, n=43) according to this cutoff. Clinical data were compared between the two groups. The Kaplan-Meier method was used to calculate survival rates and the Log-rank test was performed. Multivariate COX regression analysis was used to evaluate the impact of CHR on MACE events after PCI in SCAD patients. Results: A total of 204 patients were included, with a median follow-up time of 730 days. During follow-up, 28 MACE cases occurred, accounting for approximately 13.7%. The high CHR group had higher age, CRP levels, and proportion of MACE than the low CHR group, while LVEF and hemoglobin levels were lower (all P<0.05). ROC curve analysis showed that the area under the curve (AUC) for CHR in assessing MACE after PCI for SCAD was 0.70 (95% CI: 0.57~0.82, P=0.001), with an optimal cutoff value of 0.028, sensitivity of 59.3%, and specificity of 83.9%. Kaplan-Meier curves indicated that the MACE incidence was higher in the high CHR group than in the low CHR group (Log-rank P<0.001). Multivariate COX regression analysis showed that the MACE incidence in the high CHR group was 4.30 times that of the low CHR group (HR=4.30, 95% CI: 1.47~12.55, P=0.008). Conclusion: CHR is an independent predictor of MACE after PCI in patients with SCAD and requires clinical attention.