Positive association between uric acid-to-albumin ratio and long-term mortality in patients undergoing elderly heart valve surgery
WANG Yu-ru
GU Bo-wen
BAO Rong-xing
GU Xiao-lin
HE Hai-lin
Abstract：Background The uric acid to albumin ratio (UAR) has emerged as a potential biomarker for systemic inflammation and oxidative stress, both of which are implicated in adverse outcomes following cardiac surgery. This study aimed to explore the association between UAR and long-term mortality in elderly patients undergoing heart valve surgery. Methods A retrospective cohort study was conducted on 202 elderly patients who underwent valve surgery in the Cardiac Surgery Intensive Care Unit (CSICU) between January 2013 and April 2014. Patients were stratified into three groups based on UAR level (low: 5.66-10.26; middle: 10.29-13.47; high: 13.48-31.88). The multivariable Cox regression analysis with covariate adjustment and subgroup analyses were performed to evaluate the association between UAR and long-term mortality, with a median follow-up period of 7.9 years. Smooth curve fitting was used to evaluate the potential linear association between UAR and long-term follow-up mortality. Kaplan-Meier curves with log-rank tests were generated to compare survival distributions among UAR groups. Results In multivariate regression models, UAR demonstrated a significant positive association with long-term follow-up mortality after comprehensive covariates adjustment. The adjusted hazard ratios (HR) for long-term follow-up mortality was 1.22 (95%CI: 1.10-1.34, P<0.0001) per 1-unit increase in UAR. We further performed exploratory subgroup analyses which confirmed a higher UAR levels were independently associated with a higher risk of mortality. Kaplan-Meier analysis for event-free survival revealed higher occurrence of long-term follow-up mortality in the high UAR group (P=0.013). Conclusions Elevated UAR levels in elderly patients who underwent valvular surgery in the CSICU demonstrated a positive correlation with mortality risk. [S Chin J Cardiol 2025;26(2):69-77]
Keywords：Uric acid to albumin ratioMortalityHeart valvesElderly
Publication Date：2025-06-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：10( 69-77,87 )