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

Wändell, Per ; Carlsson, Axel C. ; Larsson, Anders O. ; Ärnlöv, Johan ; Ruge, Toralph LU and Rydell, Andreas (2024) In BMC Cardiovascular Disorders 24(1).
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,... (More)

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).

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Albumin, Blood pressure, Cardiovascular mortality, CRP, Diabetes
in
BMC Cardiovascular Disorders
volume
24
issue
1
article number
326
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85197201896
  • pmid:38926672
ISSN
1471-2261
DOI
10.1186/s12872-024-03995-9
language
English
LU publication?
yes
id
b79d239f-cb2a-4c27-aed6-e9fca083d8ab
date added to LUP
2024-08-29 15:04:52
date last changed
2024-08-30 03:00:02
@article{b79d239f-cb2a-4c27-aed6-e9fca083d8ab,
  abstract     = {{<p>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 (&lt; 10 and ≥ 10 mg/ml) and age (&lt; 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).</p>}},
  author       = {{Wändell, Per and Carlsson, Axel C. and Larsson, Anders O. and Ärnlöv, Johan and Ruge, Toralph and Rydell, Andreas}},
  issn         = {{1471-2261}},
  keywords     = {{Albumin; Blood pressure; Cardiovascular mortality; CRP; Diabetes}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Cardiovascular Disorders}},
  title        = {{The predictive value of cardiovascular outcomes and mortality assessed by the C-reactive protein to albumin ratio in the UK Biobank}},
  url          = {{http://dx.doi.org/10.1186/s12872-024-03995-9}},
  doi          = {{10.1186/s12872-024-03995-9}},
  volume       = {{24}},
  year         = {{2024}},
}