Key result
Elevated C-reactive protein-to-albumin ratio predicts higher new-onset CAD risk in both normoglycemic and diabetic patients.
Why the study?
The study aimed to explore the potential connection between the C-reactive protein-to-albumin ratio and new-onset CAD across varying glucose levels and determine its correlation with coronary atherosclerosis severity.
Does an elevated C-reactive protein-to-albumin ratio predict new-onset coronary artery disease and its severity across different glucose metabolic states?
Cohort (n=1,489)
Does an elevated C-reactive protein-to-albumin ratio predict new-onset coronary artery disease and its severity across different glucose metabolic states?
Effect estimate: AUC 0.638 (95% CI 0.605-0.672)
The C-reactive protein-to-albumin ratio serves as an independent predictor for new-onset CAD and coronary lesion severity, with its predictive efficacy being most pronounced in normoglycemic and diabetic patients.
CAR was associated with new-onset CAD risk across glycemic states; hypothesis-generating and requires prospective validation before clinical use.
The C-reactive protein-to-albumin ratio (CAR) integrates inflammatory and nutritional status.The study aimed to explore the potential connection between CAR and new-onset coronary artery disease (CAD) presence across varying glucose levels and to determine its correlation with the severity of coronary atherosclerosis. The retrospective cohort comprised 1489 individuals receiving coronary angiography for the first time. Using glycemic status criteria, the cohort was divided into 3 subgroups: normoglycemic (NGR, n = 255), prediabetic mellitus (Pre-DM, n = 617), and diabetic mellitus (DM, n = 618). CAR quartiles were analyzed for associations with CAD presence and Gensini score using multivariable logistic regression. And the predictive utility of the CAR for CAD was determined via analysis of the receiver operating characteristic curve. After multivariate adjustment, elevated CAR independently predicted new-onset CAD risk in the overall cohort. Stratified by glucose metabolism, the highest CAR quartile (Q4) significantly increased CAD risk in NGR (odds ratio [OR] = 4.25, P < .05) and DM (OR = 2.29, P < .05), while the association in Pre-DM attenuated post-adjustment. Critically, CAR robustly correlated with CAD severity in Pre-DM and DM, most pronounced in DM. CAR predicted CAD overall (area under the curve = 0.638, 95% confidence interval: 0.605–0.672), outperforming isolated CRP or albumin. CAR serves as an independent predictor for new-onset CAD and coronary lesion severity, with predictive efficacy modulated by glucose metabolic states. Its association with CAD risk is pronounced in NGR and DM, while Pre-DM exhibits attenuated significance.
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Han et al. (2026) conducted a cohort in new-onset coronary artery disease (n=1,489). C-reactive protein-to-albumin ratio (CAR) vs. Lower CAR quartiles was evaluated on New-onset coronary artery disease (AUC 0.638, 95% CI 0.605-0.672). Elevated C-reactive protein-to-albumin ratio predicted new-onset CAD overall (AUC 0.638; 95% CI 0.605-0.672) and increased risk in normoglycemic (OR 4.25) and diabetic (OR 2.29) patients.
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