The Relationship of C-Reactive Protein to Albumin Ratio with Three-Month Survival in Hospitalized Patients with Heart Failure

Aim of the study: This study aimed to investigate the association of the C-reactive protein (CRP) to albumin ratio with three-month survival after hospitalization for heart failure. Methods: Patients hospitalized for heart failure at Department of Cardiology, University Hospital Centre Osijek in the period of 10 months were included. Results: There were 145 patients, of whom 67 (46.2%) were male and 78 (53.8%) female. The median age was 74 years (interquartile range 65–82 years). The most common comorbidities were hypertension (83.4%) and atrial fibrillation (58.6%). Patients treated with mineralocorticoid receptor antagonist (P = 0.02) and furosemide (P = 0.04) had a significantly higher CRP/albumin ratio. A significant positive correlation of CRP/albumin ratio was observed with neutrophil percentage, red cell distribution width, N-terminal pro-B-type natriuretic peptide, and urate concentration, whereas a significant negative correlation of CRP/albumin ratio was observed with diastolic arterial pressure, lymphocyte percentage, haemoglobin, prothrombin time and sodium concentration. Elevated CRP/albumin ratio was associated with higher mortality during the three-month follow-up (P = 0.04). Additionally, higher mortality was observed in patients with chronic obstructive pulmonary disease, a mineralocorticoid receptor antagonist and furosemide in therapy, lower systolic and diastolic blood pressure as well as higher urea, creatinine and urate concentration.Conclusion: The CRP/albumin ratio shows a greater association with the three-month survival of hospitalized patients for heart failure than CRP and albumin individually.