Predictive value of the serum homocysteine-to-albumin ratio for major adverse cardiovascular events after acute myocardial infarction: a retrospective cohort study
BackgroundAcute myocardial infarction (AMI) remains a major global health burden, with major adverse cardiovascular events (MACE) significantly affecting long-term prognosis. Although the Global Registry of Acute Coronary Events (GRACE) score is widely used for risk stratification, its complexity li...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1574139/full |
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| author | Jiaping Wang Jianling Zhou Na Wang Meili Fu Ziwen Song Ming Hu Huiyi Wu Runfeng Sun |
| author_facet | Jiaping Wang Jianling Zhou Na Wang Meili Fu Ziwen Song Ming Hu Huiyi Wu Runfeng Sun |
| author_sort | Jiaping Wang |
| collection | DOAJ |
| description | BackgroundAcute myocardial infarction (AMI) remains a major global health burden, with major adverse cardiovascular events (MACE) significantly affecting long-term prognosis. Although the Global Registry of Acute Coronary Events (GRACE) score is widely used for risk stratification, its complexity limits its clinical utility, especially in resource-limited settings. The serum homocysteine-to-albumin ratio (HAR) is a novel biomarker that combines oxidative stress and inflammatory processes, both of which play key roles in cardiovascular pathophysiology. This study aimed to assess the prognostic significance of HAR for MACE in AMI patients.MethodsA retrospective cohort study was conducted, including 421 AMI patients admitted to Donghai Hospital from January 2022 to December 2023. Clinical and laboratory data, including homocysteine (Hcy), albumin (Alb), and HAR, were collected. The primary outcome was MACE, defined as cardiovascular mortality, non-fatal myocardial infarction, heart failure, recurrent revascularization, stroke, and severe arrhythmias. Multivariable Cox regression analysis was performed to identify independent predictors of MACE. The predictive performance of HAR was assessed using receiver operating characteristic (ROC) curve analysis and compared with Hcy, Alb, and the GRACE score.ResultsDuring the 12-month follow-up period, 105 patients (24.9%) experienced MACE. The MACE group had significantly higher Hcy levels (15.7 ± 3.4 vs. 12.6 ± 3.1 μmol/L, P < 0.001) and lower Alb levels (34.2 ± 3.9 vs. 38.5 ± 4.2 g/L, P < 0.001). HAR was independently associated with MACE (HR = 1.41, 95% CI: 1.20–1.65, P < 0.001). ROC analysis demonstrated that HAR (AUC = 0.80) outperformed Hcy (AUC = 0.66) and Alb (AUC = 0.73) in predicting MACE, with predictive accuracy comparable to the GRACE score (AUC = 0.82).ConclusionsHAR is a strong and independent predictor of MACE in AMI patients. Given its simplicity, cost-effectiveness, and availability, HAR may serve as a valuable biomarker for cardiovascular risk stratification, especially in resource-limited settings. Further prospective studies are warranted to validate these findings and explore potential clinical applications. |
| format | Article |
| id | doaj-art-6c8618ed89f1489bbe63a7066c70bf21 |
| institution | DOAJ |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-06-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-6c8618ed89f1489bbe63a7066c70bf212025-08-20T03:21:50ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-06-011210.3389/fcvm.2025.15741391574139Predictive value of the serum homocysteine-to-albumin ratio for major adverse cardiovascular events after acute myocardial infarction: a retrospective cohort studyJiaping Wang0Jianling Zhou1Na Wang2Meili Fu3Ziwen Song4Ming Hu5Huiyi Wu6Runfeng Sun7Department of Laboratory Medicine, Donghai People’s Hospital Affiliated to Kangda College of Nanjing Medical University, Lianyungang, ChinaDepartment of Cardiology, Donghai People’s Hospital Affiliated to Kangda College of Nanjing Medical University, Lianyungang, ChinaDepartment of Laboratory Medicine, Donghai People’s Hospital Affiliated to Kangda College of Nanjing Medical University, Lianyungang, ChinaDepartment of Laboratory Medicine, Donghai People’s Hospital Affiliated to Kangda College of Nanjing Medical University, Lianyungang, ChinaDepartment of Laboratory Medicine, Donghai People’s Hospital Affiliated to Kangda College of Nanjing Medical University, Lianyungang, ChinaDepartment of Laboratory Medicine, Donghai People’s Hospital Affiliated to Kangda College of Nanjing Medical University, Lianyungang, ChinaDepartment of Laboratory Medicine, Donghai People’s Hospital Affiliated to Kangda College of Nanjing Medical University, Lianyungang, ChinaDepartment of Cardiology, Donghai People’s Hospital Affiliated to Kangda College of Nanjing Medical University, Lianyungang, ChinaBackgroundAcute myocardial infarction (AMI) remains a major global health burden, with major adverse cardiovascular events (MACE) significantly affecting long-term prognosis. Although the Global Registry of Acute Coronary Events (GRACE) score is widely used for risk stratification, its complexity limits its clinical utility, especially in resource-limited settings. The serum homocysteine-to-albumin ratio (HAR) is a novel biomarker that combines oxidative stress and inflammatory processes, both of which play key roles in cardiovascular pathophysiology. This study aimed to assess the prognostic significance of HAR for MACE in AMI patients.MethodsA retrospective cohort study was conducted, including 421 AMI patients admitted to Donghai Hospital from January 2022 to December 2023. Clinical and laboratory data, including homocysteine (Hcy), albumin (Alb), and HAR, were collected. The primary outcome was MACE, defined as cardiovascular mortality, non-fatal myocardial infarction, heart failure, recurrent revascularization, stroke, and severe arrhythmias. Multivariable Cox regression analysis was performed to identify independent predictors of MACE. The predictive performance of HAR was assessed using receiver operating characteristic (ROC) curve analysis and compared with Hcy, Alb, and the GRACE score.ResultsDuring the 12-month follow-up period, 105 patients (24.9%) experienced MACE. The MACE group had significantly higher Hcy levels (15.7 ± 3.4 vs. 12.6 ± 3.1 μmol/L, P < 0.001) and lower Alb levels (34.2 ± 3.9 vs. 38.5 ± 4.2 g/L, P < 0.001). HAR was independently associated with MACE (HR = 1.41, 95% CI: 1.20–1.65, P < 0.001). ROC analysis demonstrated that HAR (AUC = 0.80) outperformed Hcy (AUC = 0.66) and Alb (AUC = 0.73) in predicting MACE, with predictive accuracy comparable to the GRACE score (AUC = 0.82).ConclusionsHAR is a strong and independent predictor of MACE in AMI patients. Given its simplicity, cost-effectiveness, and availability, HAR may serve as a valuable biomarker for cardiovascular risk stratification, especially in resource-limited settings. Further prospective studies are warranted to validate these findings and explore potential clinical applications.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1574139/fullacute myocardial infarctionhomocysteinealbuminhomocysteine-to-albumin ratiomajor adverse cardiovascular eventsrisk stratification |
| spellingShingle | Jiaping Wang Jianling Zhou Na Wang Meili Fu Ziwen Song Ming Hu Huiyi Wu Runfeng Sun Predictive value of the serum homocysteine-to-albumin ratio for major adverse cardiovascular events after acute myocardial infarction: a retrospective cohort study Frontiers in Cardiovascular Medicine acute myocardial infarction homocysteine albumin homocysteine-to-albumin ratio major adverse cardiovascular events risk stratification |
| title | Predictive value of the serum homocysteine-to-albumin ratio for major adverse cardiovascular events after acute myocardial infarction: a retrospective cohort study |
| title_full | Predictive value of the serum homocysteine-to-albumin ratio for major adverse cardiovascular events after acute myocardial infarction: a retrospective cohort study |
| title_fullStr | Predictive value of the serum homocysteine-to-albumin ratio for major adverse cardiovascular events after acute myocardial infarction: a retrospective cohort study |
| title_full_unstemmed | Predictive value of the serum homocysteine-to-albumin ratio for major adverse cardiovascular events after acute myocardial infarction: a retrospective cohort study |
| title_short | Predictive value of the serum homocysteine-to-albumin ratio for major adverse cardiovascular events after acute myocardial infarction: a retrospective cohort study |
| title_sort | predictive value of the serum homocysteine to albumin ratio for major adverse cardiovascular events after acute myocardial infarction a retrospective cohort study |
| topic | acute myocardial infarction homocysteine albumin homocysteine-to-albumin ratio major adverse cardiovascular events risk stratification |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1574139/full |
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