In a recent study, diabetic people undergoing percutaneous coronary intervention (PCI) had worse 5-year outcomes when their high-sensitivity C-reactive protein (hs-CRP)-to-albumin ratio (CAR) levels were higher. Individuals suffering from coronary artery disease combined with diabetes are at a greater risk of cardiovascular events. CAR is a new inflammatory biomarker. But, whether CAR can recognize high-risk people suffering from type 2 diabetes mellitus (T2DM) and coronary artery disease is not clear.

This real-world cohort study was based on an observational and prospective cohort encompassing 10,724 volunteers who were scheduled to undergo PCI with dual antiplatelet therapy. All-cause mortality was the key endpoint while cardiac mortality served as the secondary endpoint. Using the formula: hs-CRP (mg/L)/albumin (g/L), CAR was computed. Volunteers were separated into higher CAR (CAR-L) and lower CAR (CAR-L) groups based on the ideal CAR cut-off value for all-cause death.

Final enrollment included 2755 T2DM people who had PCI and received dual antiplatelet treatment. A 5-year follow-up (interquartile range: 5.0–5.1 years) revealed 126 (4.6%) all-cause fatalities and 74 (2.7%) cardiac fatalities. CAR-H was linked to an escalated risk of all-cause death (hazard ratio [HR]: 1.634) and cardiac mortality (HR: 1.733) in comparison with CAR-L in the multivariable Cox model.

CAR outperformed hs-CRP in terms of predictive value for both cardiac mortality (area under the curve [AUC] 0.602 vs. 0.593) and all-cause mortality (AUC 0.588 vs. 0.580). Hence, individuals with T2DM treated with PCI who have raised CAR levels experience more risk of long-term mortality (cardiac and all-cause mortality) than those with reduced levels of CAR.