The diagnostic value of serum C-reactive protein/albumin and homocysteine/high-density lipoprotein-cholesterol in coronary microvascular angina pectoris

血清C反应蛋白/白蛋白和同型半胱氨酸/高密度脂蛋白胆固醇在冠状动脉微血管性心绞痛诊断中的价值

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Abstract

OBJECTIVE: The aim of this study was to investigate the correlation between the serum C-reactive protein/albumin ratio and homocysteine/high-density lipoprotein-cholesterol ratio with microvascular angina and assess their predictive value. METHODS: A total of 70 patients diagnosed with microvascular angina comprised the observation group, while 68 patients with normal or minimal (<50%) coronary stenosis and normal coronary blood flow formed the control group. Serum C-reactive protein, albumin, homocysteine, high-density lipoprotein-cholesterol, and other indexes were measured, and C-reactive protein/albumin and homocysteine/high-density lipoprotein-cholesterol ratios were calculated. Logistic regression, Pearson's correlation, and receiver operating characteristic analyses were conducted to identify independent risk factors for microvascular angina. RESULTS: Significant differences in C-reactive protein, C-reactive protein/albumin, homocysteine, and homocysteine/high-density lipoprotein-cholesterol levels were found between the microvascular angina and control groups (p<0.05). Multivariate logistic regression analysis showed that C-reactive protein, C-reactive protein/albumin, homocysteine, and homocysteine/high-density lipoprotein-cholesterol were independent risk factors for microvascular angina, with the risk increasing alongside elevated C-reactive protein/albumin and homocysteine/high-density lipoprotein-cholesterol levels. The receiver operating characteristic analysis demonstrated that C-reactive protein/albumin, homocysteine/high-density lipoprotein-cholesterol, and their combined use were predictive of microvascular angina, with the combined area under the curve value exceeding that of individual markers. CONCLUSIONS: Elevated C-reactive protein/albumin and homocysteine/high-density lipoprotein-cholesterol offer predictive value for microvascular angina diagnosis, with the combination providing superior diagnostic accuracy over individual indicators, supporting early microvascular angina identification.

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