Key result
Elevated high-sensitivity C-reactive protein to albumin ratio (≥0.075 mg/g) significantly increased the risk of all-cause death (HR 1.77) and cardiac death (HR 2.99) in community CHD patients.
Why the study?
The study aimed to explore the association of the high-sensitivity C-reactive protein to albumin ratio with death events in community-based patients with coronary heart disease.
Does an elevated high-sensitivity C-reactive protein to albumin ratio (CAR) predict all-cause and cardiac death in community-based patients with coronary heart disease?
Cohort (n=624)
Does an elevated high-sensitivity C-reactive protein to albumin ratio (CAR) predict all-cause and cardiac death in community-based patients with coronary heart disease?
Hazard Ratio: 1.77 (95% CI 1.15–2.74)
Absolute Event Rate: 19.3% vs 12.5%
p-value: p=0.010
A high-sensitivity C-reactive protein to albumin ratio (CAR) ≥0.075 mg/g is an independent predictor of all-cause and cardiac mortality in community-dwelling patients with coronary heart disease.
Elevated CAR may refine mortality risk stratification in community CHD; hypothesis-generating and needs prospective validation.
BACKGROUND: This research aimed to explore the association of high-sensitivity C-reactive protein to albumin ratio (CAR) with death events in community-based patients with coronary heart disease (CHD). METHODS: 624 CHD participants were followed for 36 months using data from the 2015-2018 National Health and Nutrition Examination Survey (NHANES). The CAR was dichotomized at 0.075 mg/g to stratify inflammation levels. Relationships between CAR, high-sensitivity C-reactive protein (hsCRP), albumin (ALB) and all-cause and cardiac death in all participants and subgroups were analyzed using restricted cubic spline (RCS), Kaplan-Meier survival curves and Cox proportional hazards models. RESULTS: Both CAR and hsCRP showed positive correlations with all-cause and cardiac death risk while ALB exhibited a U-shaped correlation with all-cause death risk but a negative correlation with cardiac death risk. The high-CAR group had higher risks of all-cause (P = 0.04) and cardiac death (P = 0.02). The hazard ratios (HR) (95% confidence intervals (CI)) for all-cause death was 1.77 (1.15-2.74) (P = 0.010), while it was 2.99 (1.44-6.22) (P = 0.003) for cardiac death. No significant interaction was observed in subgroup analyses. CONCLUSIONS: A CAR threshold of 0.075 mg/g effectively distinguished between high and low inflammation risks. Elevated CAR significantly increased the risk of all-cause and cardiac death in community CHD patients.
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Zhou et al. (2025) conducted a cohort in Coronary heart disease (n=624). High-sensitivity C-reactive protein to albumin ratio (CAR) ≥ 0.075 mg/g vs. Low CAR (< 0.075 mg/g) was evaluated on All-cause death (HR 1.77, 95% CI 1.15-2.74, p=0.010). Elevated high-sensitivity C-reactive protein to albumin ratio (≥0.075 mg/g) significantly increased the risk of all-cause death (HR 1.77) and cardiac death (HR 2.99) in community CHD patients.
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