Department of Cardiology, Ningbo Ninth Hospital, No. 68 Xiangbei Road, Jiangbei District, Ningbo, 315000, Zhejiang, China.
Department of Hyperbaric Oxygen, Rehabilitation Hospital Affiliated to National Research Center for Rehabilitation Technical Aids, Beijing, 100000, China.
J Cardiothorac Surg. 2024 Aug 23;19(1):487. doi: 10.1186/s13019-024-02988-1.
The study aimed to examine the role of the C-reactive protein to albumin ratio (CAR) as an inflammatory biomarker in relation to subclinical myocardial injury (SC-MI), addressing the limited knowledge of their association.
The study included 5,949 individuals without cardiovascular disease (CVD) from the National Health and Nutrition Examination Survey. SC-MI was identified through a Cardiac Infarction Injury Score (CIIS) of ≥ 10 units based on a 12-lead electrocardiogram. The study used multivariate logistic regression models, adjusted for potential confounders, to evaluate the relationship between CAR and SC-MI. Subgroup analyses were conducted to substantiate the results, and the non-linear correlation was assessed via restricted cubic spline (RCS) regression.
The RCS curve showed a significant positive correlation between CAR and SC-MI (P for nonlinear = 0.2496). When adjusted for all confounders, individuals in the highest tertile of CAR exhibited a higher likelihood of SC-MI compared to those in the lowest tertile, with an odds ratio (OR) of 1.21 (95% CI: 1.06-1.39, P for trend = 0.029). A 10-unit increment in CAR was linked to a 3.6% heightened risk of SC-MI [OR = 1.036 (95% CI: 1.006, 1.066)], with this association being more prominent among male adults, non-smokers, married individuals, those without diabetes mellitus, and those with no history of cancer.
The findings of this study suggest a positive correlation between CAR and SC-MI among the US adult population, indicating the potential of CAR in enhancing SC-MI prevention strategies in the general population.
本研究旨在探讨 C 反应蛋白与白蛋白比值（CAR）作为炎症生物标志物与亚临床心肌损伤（SC-MI）的关系，以弥补其相关性的知识空白。
本研究纳入了 5949 名无心血管疾病（CVD）的美国国家健康与营养调查参与者。通过基于 12 导联心电图的心肌梗死损伤评分（CIIS）≥10 单位来确定 SC-MI。本研究采用多变量逻辑回归模型，调整了潜在混杂因素，以评估 CAR 与 SC-MI 之间的关系。进行了亚组分析以验证结果，并通过限制性立方样条（RCS）回归评估非线性相关性。
RCS 曲线显示 CAR 与 SC-MI 之间存在显著正相关（P 非线性=0.2496）。在校正所有混杂因素后，与 CAR 最低三分位相比，CAR 最高三分位的个体发生 SC-MI 的可能性更高，比值比（OR）为 1.21（95%可信区间：1.06-1.39，趋势 P=0.029）。CAR 每增加 10 单位，SC-MI 的风险增加 3.6%[OR=1.036（95%可信区间：1.006, 1.066)]，这种关联在男性成年人、非吸烟者、已婚人士、无糖尿病患者和无癌症史患者中更为显著。
本研究结果表明，美国成年人中 CAR 与 SC-MI 之间呈正相关，提示 CAR 有可能增强普通人群中 SC-MI 的预防策略。
