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Background <p>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.</p> Methods <p>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.</p> Results <p>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, <i>p</i> &lt; 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, <i>p</i> = 0.005). The competing risk model revealed a similar association between HCR and cardiac mortality.</p> Conclusions <p>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.</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月5日

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  • Bo Kang,
  • Chun Zhang,
  • Jie Li,
  • Liang Chen

摘要

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.