C-reactive Protein-to-Albumin Ratio for Evaluating Patients with Chronic Limb-Threatening Ischemia Following Endovascular Therapy
Abstract
AIM: Chronic limb-threatening ischemia (CLTI), the most advanced stage of lower-extremity artery disease, is associated with high mortality and major amputation rates, even after revascularization. Thus, identifying patients with CLTI at a particularly high risk of poor outcomes is crucial for shared decision making. Recently, the C-reactive protein-to-albumin ratio (CAR) has emerged as a novel composite biomarker that reflects both the inflammatory and nutritional status. Nonetheless, the prognostic significance of CAR in patients with CLTI undergoing endovascular therapy (EVT) remains unclear. METHODS: Of 159 patients who underwent EVT for the first time between April 2010 and December 2023, 79 were included in this study. The patients were categorized into two groups using a CAR value of 0.17: the high-CAR group (CAR ≥ 0.17) and the low-CAR group (CAR ＜0.17). The primary endpoint was 1-year amputation-free survival (AFS) after EVT. RESULTS: The median follow-up period was 23 months (95% confidence interval [CI], 11-34). During the follow-up period, 56 patients (71%) died and 11 (14%) underwent major amputation. AFS was significantly reduced in the high-CAR group (log-rank P＜0.01). The CAR (hazard ratio: 1.43 per one-unit increase, 95% CI: 1.20-1.70, P＜0.01) was an independent predictor of reduced AFS following EVT. CONCLUSIONS: elevated preprocedural CAR was independently associated with reduced AFS after EVT in patients with CLTI. The CAR may serve as a valuable tool for evaluating patients with CLTI before EVT.
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BibTeX
@article{satake2026creactive,
title = {{C-reactive Protein-to-Albumin Ratio for Evaluating Patients with Chronic Limb-Threatening Ischemia Following Endovascular Therapy}},
author = {Akinori Satake and Takahiro Tokuda and Hiroaki Sawada and Masahiro Shimoda and Hirofumi Ohashi and Akihiro Suzuki and Yusuke Nakano and Hiroshi Takahashi and Akio Kodama and Makoto Narita and Tetsuya Amano},
journal = {Journal of Atherosclerosis and Thrombosis},
year = {2026},
month = nov,
doi = {10.5551/jat.66108},
url = {https://www.jstage.jst.go.jp/article/jat/33/11/33_66108/_article},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - C-reactive Protein-to-Albumin Ratio for Evaluating Patients with Chronic Limb-Threatening Ischemia Following Endovascular Therapy
AU - Akinori Satake
AU - Takahiro Tokuda
AU - Hiroaki Sawada
AU - Masahiro Shimoda
AU - Hirofumi Ohashi
AU - Akihiro Suzuki
AU - Yusuke Nakano
AU - Hiroshi Takahashi
AU - Akio Kodama
AU - Makoto Narita
AU - Tetsuya Amano
PY - 2026
DA - 2026/11/01
JO - Journal of Atherosclerosis and Thrombosis
DO - 10.5551/jat.66108
UR - https://www.jstage.jst.go.jp/article/jat/33/11/33_66108/_article
AB - AIM: Chronic limb-threatening ischemia (CLTI), the most advanced stage of lower-extremity artery disease, is associated with high mortality and major amputation rates, even after revascularization. Thus, identifying patients with CLTI at a particularly high risk of poor outcomes is crucial for shared decision making. Recently, the C-reactive protein-to-albumin ratio (CAR) has emerged as a novel composite biomarker that reflects both the inflammatory and nutritional status. Nonetheless, the prognostic significance of CAR in patients with CLTI undergoing endovascular therapy (EVT) remains unclear. METHODS: Of 159 patients who underwent EVT for the first time between April 2010 and December 2023, 79 were included in this study. The patients were categorized into two groups using a CAR value of 0.17: the high-CAR group (CAR ≥ 0.17) and the low-CAR group (CAR ＜0.17). The primary endpoint was 1-year amputation-free survival (AFS) after EVT. RESULTS: The median follow-up period was 23 months (95% confidence interval [CI], 11-34). During the follow-up period, 56 patients (71%) died and 11 (14%) underwent major amputation. AFS was significantly reduced in the high-CAR group (log-rank P＜0.01). The CAR (hazard ratio: 1.43 per one-unit increase, 95% CI: 1.20-1.70, P＜0.01) was an independent predictor of reduced AFS following EVT. CONCLUSIONS: elevated preprocedural CAR was independently associated with reduced AFS after EVT in patients with CLTI. The CAR may serve as a valuable tool for evaluating patients with CLTI before EVT.
SN - 1880-3873
SN - 1340-3478
ER -