Association of CRP Albumin Ratio with No-Reflow Phenomenon After PCI: A Systematic Review and Meta-Analysis

OBJECTIVE
No-reflow (NR), a complication of percutaneous coronary intervention (PCI), is associated with poor cardiovascular outcomes. Identifying reliable predictors of NR is crucial for risk stratification and improving clinical outcomes. The CRP-albumin ratio (CAR), a marker of systemic inflammation, has been suggested as a potential predictor of NR. This systematic review and meta-analysis aimed to evaluate the relationship of CAR with the NR after PCI.

METHODS
A comprehensive literature search was conducted in Cochrane, Embase and PubMed databases, following PRISMA 2020 guidelines. Studies evaluating the predictive value of CAR for NR were included. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed using Cochrane’s Q and I² statistics.

RESULTS
Four studies comprising 2,068 patients were included. The pooled analysis showed a significant association between higher CAR and an increased risk of NR (OR: 2.34; 95% CI: 1.19–4.60; p = 0.01; I² = 96%).

CONCLUSION
We found that elevated CAR is associated with NR after PCI, suggesting its potential utility as a prognostic biomarker. However, high heterogeneity underscores the need for large-scale studies to validate its clinical applicability.