The predictive value of cardiovascular outcomes and mortality assessed by the C-reactive protein to albumin ratio in the UK Biobank

BMC Cardiovasc Disord. 2024 Jun 26;24(1):326. doi: 10.1186/s12872-024-03995-9.

Abstract

Background: The C-reactive protein/albumin ratio (CAR) seems to mirror disease severity and prognosis in several acute disorders particularly in elderly patients, yet less is known about if CAR is superior to C-reactive protein (CRP) in the general population.

Methods: Prospective study design on the UK Biobank, where serum samples of CRP and Albumin were used. Cox regression analyses were conducted to assess all-cause and cardiovascular mortality, myocardial infarction, ischemic stroke, and heart failure over a follow-up period of approximately 12.5 years. The Cox model was adjusted for established cardiovascular disease (CVD) risk factors, including age, sex, smoking habits, physical activity level, BMI level, systolic blood pressure, LDL-cholesterol, statin treatment, diabetes, and previous CVD, with hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Analyses were also stratified by sex, CRP level (< 10 and ≥ 10 mg/ml) and age (< 60 and ≥ 60 years).

Results: In total, 411,506 individuals (186,043 men and 225,463 women) were included. In comparisons between HRs for all adverse outcomes, the results were similar or identical for CAR and CRP. For example, both CAR and CRP, adjusted HRs for all-cause mortality were 1.13 (95% CI 1.12-1.14). Regarding CVD mortality, the adjusted HR for CAR was 1.14 (95% CI 1.12-1.15), while for CRP, it was 1.13 (95% CI 1.11-1.15).

Conclusions: Within this study CAR was not superior to CRP in predictive ability of mortality or CVD disorders.

Clinical trial registration number: Not applicable (cohort study).

Keywords: Albumin; Blood pressure; CRP; Cardiovascular mortality; Diabetes.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biological Specimen Banks*
  • Biomarkers* / blood
  • C-Reactive Protein* / analysis
  • Cardiovascular Diseases* / blood
  • Cardiovascular Diseases* / diagnosis
  • Cardiovascular Diseases* / mortality
  • Cause of Death
  • Female
  • Heart Disease Risk Factors
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests*
  • Prognosis
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Serum Albumin, Human / analysis
  • Time Factors
  • UK Biobank
  • United Kingdom / epidemiology

Substances

  • C-Reactive Protein
  • Biomarkers
  • Serum Albumin, Human
  • ALB protein, human