Relationship between lactate albumin ratio and mortality in patients with ischemia and non-obstructive coronary artery disease (INOCA)

Abstract

Aim: Ischemia with non-obstructive coronary artery disease (INOCA) is when there is myocardial ischemia without occlusive coronary artery disease. Over time, this could result in a reduced quality of life, frequent hospital visits, and a higher risk of cardiovascular-related deaths. Diagnosis, management, and prognosis of INOCA pose challenges. Lactate-albumin ratio (LAR) has been associated with mortality from many cardiovascular diseases. The study examined the link between LAR and mortality in patients with INOCA.

Materials and Methods: The study analyzed data from 987 patients diagnosed with ischemia through myocardial perfusion imaging using single photon emission computed tomography (MPI-SPECT) at our center between 2017 and 2023. After applying the exclusion criteria, we included 279 patients in the study. Medical histories, laboratory parameters, and patient death information were recorded.

Results: The mean follow-up time was 205±47 days. Mortality occurred in 5% of patients (14 patients). Patients were divided into two groups: mortality and non-mortality. The LAR was 0.65 ± 0.26 in the non-mortality group and 1.05 ± 0.32 in the mortality group, indicating a meaningful disparity between the two groups (p=0.017). Cox regression analysis was conducted to determine mortality predictors. In INOCA patients, mortality was independently predicted by age and LAR (p=0.03, and p=0.005, respectively). To evaluate the efficacy of LAR in predicting mortality, we executed the Receiver Operating Characteristic (ROC) analysis. The examination revealed an area under the curve (AUC) of 0.689 (0.519-0.858), a cut-off of 0.656, a sensitivity of 57.1%, and a specificity of 52.8% (p=0.017).

Conclusion: Our study found that LAR performs as an independent predictor of mortality in patients with INOCA.