Preoperative Serum Albumin-to-Creatinine Ratio Predicts 1-Year Reintervention After Above-Knee Femoropopliteal Bypass Surgery
Journal of Clinical Medicine, cilt.15, sa.12, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 15 Sayı: 12
- Basım Tarihi: 2026
- Doi Numarası: 10.3390/jcm15124466
- Dergi Adı: Journal of Clinical Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Chemical Abstracts Core, EMBASE, Academic Search Ultimate (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: femoropopliteal bypass, peripheral artery disease, prognosis, serum albumin/creatinine ratio
- Eskişehir Osmangazi Üniversitesi Adresli: Evet
Özet
Objective: Serum albumin/creatinine ratio (sACR) integrates nutritional–inflammatory status and renal reserve. We evaluated its ability to predict 1-year reintervention for symptomatic graft occlusion in patients undergoing prosthetic above-knee femoropopliteal bypass for peripheral artery disease (PAD). Methods: This single-center retrospective study included 132 adults (7 women, 125 men) who underwent Dacron above-knee femoropopliteal bypass. The primary analysis evaluated preoperative sACR as a continuous variable. For descriptive comparisons and Kaplan–Meier visualization, patients were stratified according to the median preoperative sACR value (3.77), yielding two groups: <3.77 vs. ≥3.77. The primary endpoint was reintervention for symptomatic graft occlusion confirmed by imaging. Discrimination was assessed using ROC analysis, and the ROC-derived cutoff was interpreted as an exploratory threshold rather than a validated clinical decision point. Associations with 1-year reintervention were assessed using Cox proportional hazards regression analysis (age, diabetes, hypertension, smoking, coronary artery disease, hemodialysis-dependent chronic kidney disease, hemoglobin level, GFR, total protein level, antiplatelet use, and anticoagulant use). Results: Most baseline characteristics were comparable between groups; however, hemodialysis-dependent chronic kidney disease was more frequent in the low-sACR group. Reintervention occurred significantly more often in the low-sACR group from month 1 onward. sACR significantly discriminated 1-year events (AUC = 0.736; p < 0.001). The optimal cutoff was ≤3.7 (sensitivity 90.9%, specificity 64.6%). Higher sACR was associated with lower 1-year event risk in both univariate and multivariate models (adjusted HR 0.61, 95% CI 0.43–0.87; p = 0.007). Conclusions: Preoperative sACR is a practical biomarker associated with early and 1-year reintervention risk after prosthetic above-knee femoropopliteal bypass and may aid perioperative risk stratification.