Fibrinogen to albumin and C-reactive protein to albumin ratio can play an important role in catheterization decisions in COVID-19 pneumonia patients: A retrospective cohort study

Background/Aim: Elevated troponin T (Tp) is an important indicator in the decision to catheterize. However, since COVID-19 infection may cause elevated Tp, different biomarkers are needed to make the decision for catheterization. We aimed to investigate the importance of fibrinogen-to-albumin ratio (FAR) and CRP-to-albumin ratio (CAR) values in predicting obstructive coronary artery disease (CAD) in patients hospitalized with COVID-19 pneumonia and catheterized with the suspicion of acute coronary syndrome (ACS). Methods: In this retrospective cohort study, clinical, laboratory, catheterization, and electrocardiography data of all patients were analyzed. Patients with obstructive CAD were defined as the MI group, and patients with normal coronary arteries were defined as the normal group. Results: The MI group consisted of 49 patients (66.2%), and the normal group consisted of 25 patients (33.8%). Both FAR and CAR were significantly higher in the MI group (P=0.007; P=0.009, respectively). FAR and CAR were found to be independent predictors of obstructive CAD (95% CI 0.06 [0.000-34.052], P=0.024; 95% CI 1.35 [0.803-2.255], P=0.025, retrospectively). A cut-off value of 0.64 for FAR has an 80% sensitivity and a 40% specificity, and a cut-off value of 0.65 for CAR has an 83% sensitivity and a 41% specificity in predicting obstructive CAD. Conclusion: A decision for ACS and catheterization in patients hospitalized with COVID-19 pneumonia in the ICU should not be based only on elevated Tp, as it is useful to evaluate FAR and CAR values in addition to Tp.