Egypt Heart J. 2025 Dec 5;77(1):109. doi: 10.1186/s43044-025-00707-2.
ABSTRACT
BACKGROUND: Although the hemoglobin-to-creatinine ratio (HCR) has been recognized as a predictor for various diseases, its prognostic value in patients with coronary artery disease (CAD) remains unclear. This study aimed to examine the association between HCR and all-cause mortality in general CAD patients using data from the National Health and Nutrition Examination Survey (NHANES) database.
METHODS: A total of 3701 adult patients with CAD, which was identified through self-report in questionnaires, were included and followed for a mean of 79 months. The association between HCR and all-cause mortality was evaluated using smooth curve fitting, threshold effect analysis, and a competing risk regression model.
RESULTS: A nonlinear association was observed between HCR and all-cause mortality among CAD patients, characterized by an inflection point at 18.32. Below this threshold, each unit decrease in HCR was associated with a 6% reduction in all-cause mortality (HR = 0.94, 95%CI: 0.92-0.97, p < 0.001). Above the inflection point, each unit increase in HCR corresponded to a 7% increase in mortality risk (HR =1.07, 95%CI: 1.02-1.12, p = 0.005). The competing risk model revealed a similar association between HCR and cardiac mortality.
CONCLUSIONS: Utilizing data from the nationally representative NHANES database, this study identified a nonlinear correlation between HCR and all-cause mortality in a general population of patients with CAD. Specifically, mortality risk initially decreased and subsequently increased with rising HCR levels, highlighting the broad relevance of these findings to community-based CAD management.
PMID:41348379 | DOI:10.1186/s43044-025-00707-2