CAR was independently associated with in-hospital mortality and temporary pacemaker requirement in hospitalized AV block, though it improved discrimination only modestly and was not clearly superior to its individual components.
In-hospital mortality was 14.5% and temporary pacemaker requirement (TPR) was 33.7% among 698 adults hospitalized with second-degree or higher AV block.
CAR was higher in non-survivors than in survivors.
CAR was higher in patients who required a temporary pacemaker than in those who did not.
Mortality and TPR rose across increasing CAR quartiles.
ln(1 + CAR) was independently associated with in-hospital mortality after adjustment.
ln(1 + CAR) was independently associated with TPR after adjustment.
Adding CAR to baseline models modestly improved discrimination for both mortality and TPR.
CAR showed no clear superiority over its individual components (CRP and albumin).
This study looked at 698 adults admitted to hospital with significant heart block (a problem with electrical signals in the heart, second-degree or higher). The researchers examined whether a simple blood test ratio, comparing C-reactive protein (a marker of inflammation) to albumin (a protein reflecting nutrition and overall health), was linked to outcomes. About 14.5% of patients died in hospital and about one-third needed a temporary pacemaker. Patients who died or needed a temporary pacemaker had higher ratios on admission. Death rates rose from 3.8% in the lowest-ratio group to 27.7% in the highest, and temporary pacemaker need rose from 19.7% to 48.0%. After accounting for other factors, a higher ratio was still linked to greater odds of both outcomes. This research suggests that inflammation and poor nutritional status may be markers of higher risk in heart block. However, adding the ratio improved risk prediction only modestly, and it was not clearly better than looking at C-reactive protein and albumin separately. The study was done in hospitalized patients at a single time period, so it shows association rather than proving that inflammation causes worse outcomes.
Parsova K, Pay L, Yumurtas A, Cetin T, Mollaalioglu F, Dereli S, et al.. (2026). Prognostic Value of the C-Reactive Protein-to-Albumin Ratio in Patients Hospitalized with Atrioventricular Block: Association with In-Hospital Mortality and Temporary Pacemaker Requirement.. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina62101993