Evaluation of the effectiveness of C-reactive protein/albumin ratio on thrombus in patients undergoing transesophageal echo

Left atrial appendage thrombus (LAAT) is the predominant etiology of ischemic stroke in patients with atrial fibrillation (AF), and LAAT is optimally demonstrated by transesophageal echocardiography (TEE). The study aimed to assess patients with nonvalvular atrial fibrillation (NVAF) identified with thrombus using TEE compared to those without thrombus, utilizing the C-reactive protein/albumin ratio (CAR) as a sensitive biomarker. This study was conducted retrospectively at a single center with 668 patients with NVAF who underwent TEE. Patients were divided into two groups based on the presence or absence of LAAT on TEE. The levels of CAR, C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were compared. CAR was identified as an independent variable in patients with thrombus detected on TEE. (OR: 12.773, CI: 6.669-24.464, p < 0.001) Albumin was shown to have the highest area under the curve (AUC) value for thrombus prediction, followed by CAR, CRP, NLR, and PLR, in that order. (AUC: 0.999 CI: 0.993-1.000; 0.977 (0.962-0.987); 0.931 (0.909-0.949); 0.600 (0.562-0.937) p < 0.001, AUC: 0.574 CI: 0.535-0.612 p: 0.014). Our study demonstrates that CAR serves as an independent predictor of LAAT and shows more dependability than other biomarkers such as NLR, CRP, and PLR.