Title : Association of the Uric Acid-to-Albumin Ratio with Angiographic Severity of Coronary Artery Disease in Patients Undergoing Elective Coronary Angiography
Abstract:
The uric acid-to-albumin ratio (UAR) has been proposed as a composite biomarker reflecting inflammatory and oxidative pathways relevant to coronary artery disease (CAD).¹?² Prior studies have explored its association with CAD extent and cardiovascular disease.³?? This retrospective analytical study evaluated the association between UAR and angiographic CAD severity in 150 adults who underwent elective coronary angiography at a tertiary government hospital. UAR was calculated from baseline serum uric acid and albumin levels, and CAD severity was classified angiographically, with severe CAD defined as luminal stenosis ≥70%. The median age of the cohort was 64 years, 74.7% were male, 66.0% had severe CAD, and 66.7% had multivessel disease. Median UAR for the overall cohort was 9.85 (interquartile range 7.54-12.88) and was significantly higher in patients with more severe angiographic disease; median UAR was 10.23 in the severe group versus 8.50 and 7.13 in the mild and moderate groups, respectively (p=0.012). However, in multivariable analysis, UAR was not independently associated with more advanced angiographic CAD (adjusted odds ratio 1.025, 95% confidence interval 0.895-1.173; p=0.721). For discrimination of severe CAD, UAR showed limited performance, with an area under the curve of 0.594 (95% confidence interval 0.489-0.699). A cutoff value >9.23 yielded 63.64% sensitivity and 65.0% specificity. These findings indicate that higher UAR is associated with greater angiographic CAD severity on
unadjusted analysis, but its standalone predictive utility remains limited after covariate adjustment. UAR may therefore be best interpreted as an adjunctive, low-cost laboratory marker that warrants prospective validation in larger cohorts rather than as an independent predictor of severe CAD.
Keywords: uric acid-to-albumin ratio; coronary artery disease; coronary angiography; biomarker; atherosclerosis
