High levels of high-sensitivity C reactive protein to albumin ratio can increase the risk of cardiovascular disease

Abstract

BackgroundThe high levels of C reactive protein (CRP) to albumin ratio (CAR) is thought to increase the risk of poor outcomes for cancer and cardiovascular disease (CVD). However, the association between CAR and CVD in the Chinese community population has not been investigated.ObjectiveThe aim of this study was to investigate the association between CAR and CVD in the Chinese community population.MethodsA total of 62 067 participants without a history of CVD or cancer were included in this study. Kaplan-Meier survival curves were used to calculate the cumulative incidence of endpoint events in CAR quartile groups, and the results were tested by log-rank test. Fine-Gray model was used to analyse the competing risk of death. C-index, Net Reclassification Index (NRI) and Integrated Discrimination Improvement Index (IDI) of different indicators were calculated to distinguish the predictive performance of different indicators.ResultsDuring an average follow-up period of 10.3±2.1 years, 4025 participants developed CVD. In multivariable Cox regression analysis, compared with Q1 group, model 3 showed that the hazard ratio (HR) (95% confidence interval (95%CI)) of CVD in Q4 group was 1.26 (1.15 to 1.38) (p<0.01), and the HR (95% CI) per 1 SD increase was 1.06 (1.03 to 1.08) (p<0.01). The C-index, continuous NRI and IDI for predicting 10-year CVD were 73.48%, 0.1366 (0.1049 to 0.1684) (p<0.01) and 0.0002 (0.0001 to 0.0004) (p<0.01), respectively, which were higher than those of hs-CRP (C-index:0.7344, NRI:0.0711, IDI: 0.0001) and albumin (C-index:0.7339, NRI: −0.0090, IDI: 0.0000).ConclusionHigh levels of CAR can increase the risk of CVD and the predictive performance of CAR for CVD is better than that of hs-CRP or albumin alone.

High C-reactive protein-to-albumin ratio levels are associated with osteoporosis in patients with primary biliary cholangitis

“…Consistent with our observations, Yang et al. ( 23 ) found that the predictive performance of CAR for cardiovascular disease was better than that of CRP or albumin alone. In addition, our results showed that hemoglobin and eGFR were independently associated with odds of developing OP in patients with PBC.…”

“…The CRP-to-albumin ratio (CAR) is a composite measure and is considered a more useful indicator than either CRP or albumin alone ( 22 ). As an inflammation-based marker, CAR has shown prognostic value in several diseases such as cardiovascular disease, autoimmune disease, and malignancy ( 23 – 25 ). However, the relationship between the CAR and OP development in patients with PBC remains unclear.…”

Evaluation of the Prognostic Role of Neutrophil-Lymphocyte Ratio, C-Reactive Protein-Albumin Ratio, and Platelet-Lymphocyte Ratio in Patients with the Co-Presentation of Coronary Artery Disease and COVID-19

“…Some studies also found that CRP-albumin ratio (CAR) may be an important indicator for predicting cardiovascular risk. [5][6][7][8][9] Our previous studies 10,11 also confirmed that the combined indicator of CRP and albumin played a similar role in evaluating the prognosis of patients with acute myocardial infarction as the Global Registry of Acute Coronary Events (GRACE) score. In addition, platelet-lymphocyte ratio (PLR) was also found to have good predictive value for cardiovascular events.…”

“…There have been several studies evaluating the efficacy of the NLR, CAR, and PLR in patients with CAD or COVID-19, and showed that these inflammatory scores have good clinical utility in predicting all-cause mortality in CAD or COVID-19. [4][5][6][7][8][12][13][14][15][16][17] However, few studies evaluated whether these inflammatory scores could effectively predict the prognosis for patients with CAD complicated with COVID-19.…”

Correlation between Neutrophil-to-Lymphocyte Ratio, Platelets-to-Lymphocyte Ratio, C-Reactive Protein-to-Albumin Ratio and Clinical Picture of Elderly Chronic Heart Failure Patients

“…A large data set derived from the study of Yang et al indicated the role of high CAR as a risk factor of cardiovascular disease development, even better than CRP or albumin [22]. As for the prognostic value of CAR, recently, Sonsöz et al investigated CAR in acute HF and noticed an increased mortality in the follow-up of the group of patients with high…”