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C-Reactive Protein to Serum Albumin Ratio Is an Independent Predictor of All-Cause Mortality in Patients with ANCA-Associated Vasculitis

 Jae-Seung Moon  ;  Sung Soo Ahn  ;  Yong-Beom Park  ;  Sang-Kyou Lee  ;  Sang-Won Lee 
 YONSEI MEDICAL JOURNAL, Vol.59(7) : 865-871, 2018 
Journal Title
Issue Date
Adult ; Aged ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/blood ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/immunology ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/mortality* ; Antibodies, Antineutrophil Cytoplasmic/immunology ; C-Reactive Protein/metabolism* ; Female ; Humans ; Hypertension/complications ; Male ; Microscopic Polyangiitis/immunology ; Microscopic Polyangiitis/mortality* ; Middle Aged ; Mortality* ; Proportional Hazards Models ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Serum Albumin/metabolism* ; Survival Rate
Antineutrophil cytoplasmic antibody ; albumin ; c-reactive protein ; mortality ; vasculitis
PURPOSE: We investigated whether C-reactive protein (CRP) to serum albumin ratio (CAR) could be an independent predictor of all-cause mortality in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). MATERIALS AND METHODS: We retrospectively reviewed the medical records of 170 patients with AAV. We collected clinical and laboratory data. We also examined AAV-related and traditional risk factors of all-cause mortality. To assess the hazard ratios of variables, we performed univariable and multivariable Cox hazard model analyses. RESULTS: The mean age was 55.0 years and 53 patients (31.2%) were male among 170 patients with AAV (88 microscopic polyangiitis, 43 granulomatosis with polyangiitis, and 39 eosinophilic granulomatosis with polyangiitis). ANCA was detected in 129 patients (75.9%). The initial mean CRP and serum albumin were 41.1 (mg/L) and 3.6 (g/dL), and the mean CAR at diagnosis was 14.8. The most common risk factor of mortality was hypertension (42.4%), followed by chronic kidney disease ≥stage 3 (25.9%). Fourteen patients (8.2%) died during the mean follow-up of 56.7 months. In both multivariable Cox hazard model analyses, CAR at diagnosis was identified as an independent predictor of all-cause of mortality comparable to diabetes mellitus (DM). Moreover, patients with CAR ≥10.35 and having DM exhibited a higher frequency of all-cause mortality than those without. CONCLUSION: CAR at diagnosis can be an independent predictor of all-cause mortality, comparable to DM, the conventional risk factor of mortality.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yong Beom(박용범)
Ahn, Sung Soo(안성수) ORCID logo https://orcid.org/0000-0002-9002-9880
Lee, Sang Won(이상원) ORCID logo https://orcid.org/0000-0002-8038-3341
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