Preoperative C-reactive protein/Albumin Ratio and Outcomes After Isolated CABG

Background: Inflammation plays an important role in the development of complications following coronary artery bypass graft (CABG) surgery. C-reactive protein-to-albumin (CRP/Alb) ratio is a novel biomarker that reflects the inflammatory burden and nutritional status. The present study aimed to investigate the utility of preoperative CRP/Alb ratio in predicting postoperative atrial fibrillation (POAF) and intensive care unit (ICU) length of stay in patients undergoing isolated CABG surgery. Methods: This retrospective study included 179 patients who underwent isolated CABG surgery between January 2019 and December 2023. Demographic characteristics, laboratory findings, surgical data, and postoperative outcomes were obtained from hospital records. Preoperative CRP/Alb ratios were calculated using serum CRP and albumin levels. The relationship of the CRP/Alb ratio with POAF development and ICU length of stay was evaluated. Results: During the study period, 26 patients (14.5%) experienced POAF. The preoperative CRP/Alb ratio was significantly associated with POAF development (p = 0.043), and patients who did not develop POAF had higher CRP/Alb ratios. Additionally, the CRP/Alb ratio exhibited a weak, albeit statistically significant, positive correlation with ICU length of stay (Spearman’s r = 0.186, p = 0.013). Conclusions: The preoperative CRP/Alb ratio was associated with the development of POAF and ICU length of stay in patients undergoing isolated CABG surgery. As an easily available, low-cost, and widely available biomarker, the CRP/Alb ratio may be useful for preoperative risk assessment in these patients. Key words: atrial fibrillation; C-reactive protein/albumin ratio; coronary artery bypass grafting; inflammation; intensive care unit; length of stay; postoperative