Association between hemoglobin-to-creatinine ratio and all-cause mortality in patients with coronary artery disease.

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.