Evidence mapPaperPMID 42216136Full record

SynthesisBMC cardiovascular disorders2026

C-reactive protein-to-albumin ratio and the mortality of patients with heart failure: a meta-analysis.

Yan Wang, Zhenfei Yuan

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

2 authors.

Yan WangEmergency Department of West China Hospital, Sichuan University/West China School of Nursing, Chengdu, 610000, China.
Zhenfei YuanEmergency Department of West China Hospital, Sichuan University/West China School of Nursing, Chengdu, 610000, China. Zhenfei_yuan2024@hotmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe C-reactive protein-to-albumin ratio (CAR) reflects the interplay between systemic inflammation and nutritional status, and has recently been proposed as a prognostic biomarker in heart failure (HF). However, its association with mortality risk across acute decompensated HF (ADHF) and chronic HF (CHF) populations remains uncertain. This meta-analysis evaluated the relationship between baseline CAR and all-cause mortality in HF.

methodsPubMed, Embase, Web of Science, CNKI, and Wanfang were searched for relevant longitudinal studies. Risk ratios (RRs) were pooled using a random-effects model accounting for heterogeneity. Prespecified subgroup and meta-regression analyses were performed to evaluate the influence of study characteristics.

resultsTwelve cohort studies involving 6,377 patients were included. High CAR was associated with a significantly increased risk of mortality (RR = 2.34, 95% CI 1.86-2.93), with moderate heterogeneity (I² = 66%). Notably, the association was weaker in prospective studies (RR = 1.45) compared with retrospective studies (RR = 2.50). Subgroup findings were consistent across regions (Asian: RR = 2.62; Western: RR = 1.87), HF phenotype (ADHF: RR = 2.15; CHF: RR = 2.47), age (< 65 years: RR = 2.36; ≥65 years: RR = 2.33), CAR cutoff (< 0.5 mg/g: RR = 2.60; ≥0.5 mg/g: RR = 2.16), follow-up duration (< 30 months: RR = 2.20; ≥30 months: RR = 2.45), and analytic model (univariate: RR = 2.71; multivariate: RR = 1.99). Meta-regression identified no significant moderators.

conclusionsElevated baseline CAR is consistently associated with higher mortality risk in patients with HF. However, the strength of this association appears lower in prospective studies, suggesting that the overall pooled estimate may be influenced by biases inherent to retrospective designs. In addition, the clinical utility of CAR for risk stratification of patients with HF requires further validation in well-designed prospective studies.

Indexed as

C-Reactive ProteinHeart FailureSerum AlbuminBiomarkersFemaleHumansPredictive Value of TestsPrognosisRisk AssessmentRisk FactorsBiomarkersC-Reactive ProteinSerum AlbuminC-reactive protein-to-albumin ratioHeart failureMeta-analysisMortalityRisk factor

Identifiers

PMID42216136
PMCPMC13440217

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.