Higher C-Reactive Protein to Albumin Ratio Portends Long-Term Mortality in Patients with Chronic Heart Failure and...

Area of Science:

• Cardiology
• Internal Medicine
• Biomarkers

Background:

• Chronic heart failure with reduced ejection fraction (HFrEF) is a significant cause of mortality worldwide.
• Identifying reliable prognostic markers for HFrEF patients is crucial for improving patient outcomes.
• Inflammation plays a key role in the pathophysiology of heart failure.

Purpose of the Study:

• To evaluate the prognostic value of the C-reactive protein to albumin ratio (CAR) for all-cause mortality in patients with chronic HFrEF.
• To determine if CAR can serve as an independent predictor of long-term mortality in this patient population.

Main Methods:

• An observational, retrospective study included 404 patients with chronic HFrEF.
• The C-reactive protein to albumin ratio (CAR) was calculated for each patient.
• Patients were stratified into tertiles based on CAR values, and all-cause mortality was tracked over a median follow-up of 30 months.

Main Results:

• A total of 162 (40%) patients died during the follow-up period.
• Patients with higher CAR values had significantly increased all-cause mortality (median CAR 6.7 vs. 0.6, p < 0.001).
• Multivariate analysis confirmed CAR as an independent predictor of mortality (HR: 1.852, p = 0.005), with an optimal cut-off of >2.78.

Conclusions:

• The C-reactive protein to albumin ratio (CAR) is an independent predictor of long-term mortality in patients with chronic HFrEF.
• CAR is a simple, easily obtainable inflammatory marker that can aid in predicting mortality risk in HFrEF patients.
• Elevated CAR, older age, high NT-proBNP, and absence of cardiac devices are associated with increased all-cause death in HFrEF.