Diagnostic and prognostic value of CRP/albumin and RDW/albumin ratios in young patients with acute coronary syndrome

Acute Coronary Syndrome (ACS) is a common cause of emergency department admissions and remains an important contributor to morbidity and mortality. Early identification of disease severity and prognosis is particularly important in young patients with ACS. This study aimed to evaluate the diagnostic and prognostic value of the C-reactive protein to Albumin Ratio (CAR) and red cell distribution width to Albumin Ratio (RAR) in young patients with ACS. This retrospective study included 210 patients younger than 50 years of age who were diagnosed with ACS in the emergency department between January 1, 2020, and December 31, 2022. Demographic characteristics, ACS type (unstable angina, NSTEMI, and STEMI), laboratory parameters, hospitalization data, and mortality outcomes were recorded. CAR and RAR values were calculated and analyzed in relation to ACS type and mortality. Of the 210 patients, 30 (14.3%) were female and the mean age was 43.14±5.03 years. CAR (p=0.002) and RAR (p<0.001) values were significantly associated with ACS type and were highest in the STEMI group. Mortality occurred in 7(3.4%) patients, and both CAR and RAR values were significantly higher in patients who died (CAR: 27.35±20.37, p<0.001; RAR: 6.06±3.15, p=0.009). In multivariate analysis, hospitalization duration and RAR were identified as independent predictors associated with ACS classification. ROC analysis demonstrated that both CAR and RAR showed good predictive performance for mortality. CAR and RAR appear to be useful inflammatory biomarkers that may assist in the clinical classification of ACS and in the early identification of mortality risk in young patients presenting with ACS.