Evidence mapPaperPMID 42405745Full record

ArticleClinical cardiology2026

Associations of the C-Reactive Protein-Albumin-Lymphocyte Index, Red Cell Distribution Width-Albumin Ratio, and Blood Urea Nitrogen-Albumin Ratio With All-Cause and Cardiovascular Mortality Among Adults With Preclinical Heart Failure.

Huifang Su, Xiandong Liu

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Article in Clinical cardiology, 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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5 · Who and what money

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2 authors.

Huifang SuGanzhou People's Hospital, Ganzhou, China.
Xiandong LiuGanzhou People's Hospital, Ganzhou, China.ORCID https://orcid.org/0009-0005-7977-8919

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6 · The paper itself

Abstract

backgroundPreclinical heart failure (PHF) is an early stage in the heart failure continuum, yet practical indices for mortality risk assessment remain understudied. HYPOTHESIS: The C-reactive protein-albumin-lymphocyte index (CALLY), red cell distribution width-albumin ratio (RAR), and blood urea nitrogen-albumin ratio (BAR) are associated with mortality and provide additional predictive information among adults with PHF.

methodsWe analyzed adults aged ≥ 20 years with PHF from the National Health and Nutrition Examination Survey (NHANES) 1999-2010. PHF was defined by hypertension, diabetes, obesity, atherosclerotic cardiovascular disease, or prior myocardial infarction, without diagnosed heart failure. The indices were derived from baseline laboratory measurements and log-transformed. Mortality was ascertained through December 31, 2019. Associations were assessed using survey-weighted Cox models; nonlinearity, subgroup consistency across different PHF compositions, incremental predictive performance, and sensitivity analyses, including competing-risk models, were evaluated.

resultsAmong 14 717 adults with PHF contributing 186 678.5 person-years, 3801 all-cause and 1226 cardiovascular deaths occurred. Per standard deviation increase, ln CALLY was associated with lower all-cause and cardiovascular mortality (HRs, 0.85 and 0.87), whereas ln RAR (HRs, 1.28 and 1.24) and ln BAR (HRs, 1.09 and 1.18) were associated with higher mortality. ln RAR showed the most consistent improvement in exploratory incremental predictive performance beyond the base model. The directions of association were broadly consistent across different PHF compositions, and the findings remained robust in sensitivity analyses.

conclusionsCALLY, RAR, and BAR were independently associated with mortality in adults with PHF; RAR may improve mortality risk assessment.

Indexed as

Blood Urea NitrogenC-Reactive ProteinErythrocyte IndicesHeart FailureLymphocytesSerum Albumin, HumanAdultAgedBiomarkersCause of DeathFemaleFollow-Up StudiesHumansMaleMiddle AgedNutrition SurveysBiomarkersC-Reactive ProteinSerum AlbuminSerum Albumin, Humanblood urea nitrogen–albumin ratioC‐reactive protein–albumin–lymphocyte indexmortalitypreclinical heart failurered cell distribution width–albumin ratio

Identifiers

PMID42405745
PMCPMC13334882

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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.