Correlation Between the High-Sensitivity C-Reactive Protein-to-Albumin Ratio and All-Cause Mortality in Patients With...

To evaluate the correlation between the high-sensitivity C-reactive protein-to-albumin ratio (CAR) and all-cause mortality in patients with acute exacerbation of chronic heart failure (AECHF).

In this retrospective cohort study, 342 patients were enrolled from the First People's Hospital of Zhenjiang City between January 1, 2020, and December 31, 2025. Cox regression analyses, subgroup analyses, Kaplan-Meier survival curves, and receiver operating characteristic (ROC) analyses were employed to assess the association between CAR and all-cause mortality.

During a median follow-up period of 16.35 months, 95 patients (27.8%) died. Multivariate Cox regression analysis revealed that each unit increase and each standard deviation increase in CAR were associated with a 41.2% and 40.7% increased risk of all-cause mortality, respectively (HR: 1.412, 95% CI: 1.221-1.633; HR: 1.407, 95% CI: 1.219-1.625). The risk of all-cause mortality in the high CAR group was 1.778 times that of the low CAR group (HR: 1.778; 95% CI: 1.092-2.894). The robustness of the association between CAR and all-cause mortality was further corroborated by subgroup and sensitivity analyses (p < 0.05). Kaplan-Meier survival curves revealed significant survival differences across CAR subgroups, with markedly lower cumulative survival observed in the high-CAR group (p < 0.05). ROC curve indicated a weak but statistically significant predictive value for all-cause mortality risk (p = 0.025).

Higher levels of CAR are associated with a higher risk of all-cause mortality in AECHF patients.