Department of Emergency Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Cardiac Division of Emergency Intensive Care Unit, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241271382. doi: 10.1177/10760296241271382.
To investigate the relationship between C-reactive protein and albumin ratios (CAR) and all-cause and cardiovascular disease(CVD)-specific mortality in individuals with coronary heart disease(CHD).
The data from 1895 patients were extracted from the National Health and Nutrition Examination Survey (NHANES) database from 1999-2010. We used weighted COX regression analyses to explore the association between CAR, all-cause, and CVD-specific mortality. Restricted cubic spline(RCS) regression models and threshold effects analysis were used to analyze nonlinear relationships. Subgroup analyses were also performed to explore these relationships further.
During a mean follow-up of 115.78 months, 61.48% of deaths occurred, and 21.85% were due to CVD. After adjusting for potential confounders, each 1-unit increase in CAR was associated with a 65% increase in all-cause mortality and a 67% increase in CVD-specific mortality. The RCS model revealed a non-linear association between CAR and the risk of all-cause mortality and CVD-specific mortality in CHD patients (all non-linear P < 0.001). Threshold effects analysis identified inflection points in regression models of all-cause mortality (0.04, P < 0.001) and CVD-specific mortality (0.05, P = 0.0024). The interaction tests found sex, smoking and diabetes influenced the association between CAR and all-cause mortality and sex, smoking and HF influenced its association with CVD-specific mortality (all P < 0.05).
There was a nonlinear association between CAR and all-cause mortality and CVD mortality in patients with CHD, with a higher hazard ratio before the inflection point. Sex, smoking, diabetes, and HF might have an effect on the associations between CAR and death risks.
探讨 C 反应蛋白与白蛋白比值（CAR）与冠心病患者全因和心血管疾病（CVD）死亡率的关系。
从 1999 年至 2010 年的国家健康和营养调查（NHANES）数据库中提取了 1895 名患者的数据。我们使用加权 COX 回归分析来探讨 CAR 与全因和 CVD 死亡率之间的关系。限制性三次样条（RCS）回归模型和阈值效应分析用于分析非线性关系。还进行了亚组分析以进一步探讨这些关系。
在平均 115.78 个月的随访期间，61.48%的患者死亡，其中 21.85%死于 CVD。在调整了潜在混杂因素后，CAR 每增加 1 单位，全因死亡率增加 65%，CVD 特异性死亡率增加 67%。RCS 模型显示 CAR 与 CHD 患者全因死亡率和 CVD 特异性死亡率之间存在非线性关系（所有非线性 P<0.001）。阈值效应分析确定了全因死亡率（0.04，P<0.001）和 CVD 特异性死亡率（0.05，P=0.0024）回归模型中的拐点。交互检验发现，性别、吸烟和糖尿病影响了 CAR 与全因死亡率之间的关系，性别、吸烟和 HF 影响了其与 CVD 特异性死亡率之间的关系（均 P<0.05）。
CAR 与 CHD 患者的全因死亡率和 CVD 死亡率之间存在非线性关系，在拐点之前的危险比更高。性别、吸烟、糖尿病和 HF 可能会对 CAR 与死亡风险之间的关系产生影响。
