Relationship of Red Cell Distribution Width and Uric Acid–Albumin Ratio with Coronary Artery Calcium Score in Patients with Coronary Artery Disease

Background The coronary artery calcium score is widely used to assess the extent of coronary atherosclerosis and future cardiovascular risk. Red cell distribution width and the uric acid–albumin ratio have been associated with inflammatory activity and adverse cardiovascular outcomes, but their association with coronary artery calcium burden is still not clearly established. The present study evaluated the relationship between red cell distribution width, uric acid-to-albumin ratio, and coronary artery calcium score in patients undergoing coronary computed tomography angiography for suspected coronary artery disease. Methods We conducted a hospital-based, cross-sectional observational study involving 250 patients presenting with symptoms suggestive of coronary artery disease who underwent coronary computed tomography angiography. Coronary calcium score was determined using the Agatston scoring system, and patients were grouped into low (<100) and high (≥100) coronary artery calcium score categories. Red cell distribution width-coefficient of variation, red cell distribution width-standard deviation, serum uric acid, albumin, and uric acid-to-albumin ratio were measured. Correlation analysis and logistic regression models were applied to identify factors associated with an elevated coronary calcium score. Results Sixty-five patients (26%) had a high coronary artery calcium score. Patients with elevated calcium scores were generally older and more frequently had hypertension, diabetes mellitus, a smoking history, and male predominance. Higher pulse rate, blood pressure, leukocyte count, lower albumin levels, and reduced ejection fraction were also observed. The Framingham Risk Score increased with the coronary artery calcium score. Red cell distribution width-coefficient of variation and red cell distribution width-standard deviation showed no significant association with coronary artery calcium score. Uric acid levels were similar between groups, while the uric acid-to-albumin ratio showed a weak positive correlation ( r = 0.132, P = .04) without independent predictive value. Older age, hypertension, and reduced ejection fraction independently predicted a high coronary artery calcium score. Conclusion Coronary artery calcium score remains superior for assessing atherosclerotic burden and risk stratification. Red cell distribution width showed no association, and uric acid-to-albumin ratio demonstrated only a weak, non-independent correlation.