C-reactive protein to albumin ratio and radial artery thrombosis post transradial angiography

Abstract

Aim: The aim is to evaluate the relationship between C-reactive protein (CRP) to albumin ratio (CAR) and radial artery thrombosis in patients undergoing radial angiography. Patients & methods: We prospectively included 261 consecutive patients undergoing radial angiography, assessing radial artery diameter and thrombosis presence. Results: The CRP values were significantly higher in radial artery thrombosis group compared with group without thrombosis (13.01 vs. 4.33 mg/l, p < 0.001, respectively). Also CAR was statistically significantly different between the group with thrombosis and the group without thrombosis (0.102 vs. 0.349, p < 0.001). Conclusion: Our study is the first to assess CAR in radial thrombus development post-procedure in patients undergoing radial angiography. CAR can be useful in determining radial artery thrombosis after the coronary angiography.

Summary points

• Cardiovascular diseases stand as one of the leading causes of mortality, with coronary angiography widely acknowledged as the gold standard method for diagnosing coronary artery disease.

• Many studies have shown the radial approach's advantages over the femoral approach, particularly in reducing bleeding, vascular access complications and cardiovascular events.

• Many complications can occur, such as radial artery spasm, hematoma, dissection, arteriovenous fistula, aneurysm and occlusion, as a result of the increased use of the radial approach. Radial artery occlusion is the most common complication of TRA.

• Histopathological examination of the plug from the occluded radial artery reveals a rapidly organizing thrombus.

• The CRP/albumin ratio (CAR) has been proposed as a more sensitive indicator for the severity of inflammatory reactions and disease progression.

• In cases of radial artery thrombosis (RAT), while the impact of inflammation is recognized, there is currently no study investigating its correlation with parameters assessing inflammation. This study aims to evaluate the relationship between RAT and the severity of inflammation.

• In our study, CAR was found to be higher in patients who developed radial artery thrombosis.

• CAR has been identified as independent risk factors for RAT.

• The study has certain limitations such as a small sample size, absence of factors such as the number of puncture and patent hemostasis affecting radial thrombosis formation.

• In order to evaluate CAO as a predictor of RAT formation and to generalize the results to the whole population, larger-scale, randomized and multicenter studies that include all parameters that may affect the development of RAT are needed.

Keywords: :

• C-reactive protein
• C-reactive protein to albumin ratio
• radial artery thrombosis
• transradial angiography

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, stock ownership or options and expert testimony.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval and/or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations.

In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.