Higher levels of high-sensitivity C-reactive protein-to-albumin ratio (CAR) are associated with a higher risk of all-cause mortality in patients with acute exacerbation of chronic heart failure.
Each unit increase in CAR was associated with a 41.2% increased risk of all-cause mortality in AECHF patients.
Patients in the high CAR group had 1.778 times the risk of all-cause mortality compared to the low CAR group.
During the follow-up period, 95 of 342 enrolled AECHF patients (27.8%) died.
The association between CAR and all-cause mortality was robust across subgroup and sensitivity analyses.
ROC curve analysis indicated a weak but statistically significant predictive value of CAR for all-cause mortality risk.
This research examined whether a blood test ratio — called the C-reactive protein-to-albumin ratio (CAR) — could predict the risk of death in patients hospitalized with a severe worsening of chronic heart failure. C-reactive protein is a marker of inflammation, and albumin is a protein whose low levels can indicate poor nutritional status or serious illness. The study followed 342 patients for a median of about 16 months, during which time roughly 28% of patients died. Patients with higher CAR values were significantly more likely to die than those with lower values, and this finding held up across multiple types of statistical analysis. The study found that for every one-unit increase in CAR, a patient's risk of dying increased by about 41%. Patients classified as having a 'high' CAR had nearly 1.8 times the mortality risk of those in the 'low' CAR group. While the ability of CAR alone to predict death was described as statistically significant but weak, its association with mortality was consistent across different patient subgroups. This research suggests that CAR — a relatively simple and inexpensive measure calculated from routine blood tests — may be a useful marker for identifying heart failure patients at greater risk of dying. This could potentially help clinicians prioritize monitoring or more intensive management for higher-risk individuals, though further research would be needed to determine how to best apply this measure in clinical practice.
Gu X, Feng J, Chen P, Wang H, Rui T, Guo J. (2026). Correlation Between the High-Sensitivity C-Reactive Protein-to-Albumin Ratio and All-Cause Mortality in Patients With Acute Exacerbation of Chronic Heart Failure.. Clinical cardiology. https://doi.org/10.1002/clc.70456