Can the Ratio of Calcium to Albumin Predict the Severity of Aortic Stenosis?

Objective: Aortic sclerosis is observed in 25% of the elderly population, and 2.5% of these patients have severe aortic stenosis (AS). Numerous studies have reported a relationship between the serum calcium or albumin levels and AS. The present study investigated the relationship between the calcium toalbumin ratio (CAR) and AS. Methods: Our study included 185 patients and 108 subjects as the control group. A routine transthoracic echocardiographic evaluation and laboratory examinations were performed inall participants. The corrected serum calcium levels were calculated using the most commonly used formula: corrected calcium=measured total calcium (mg/dL) + 0.8 (4.0-serum albumin [g/dL]). Results: The serum C-reactive protein CRP, calcium, and corrected calcium levels were significantly different between the study groups (p<0.05), and the albumin levels were significantly decreased parallel with the AS severity (p<0.001). Also, we detected a negative correlation between the albumin and corrected calcium levels and the EuroSCORE. CAR and corrected calcium to albumin ratio (cCAR) were significantly higher in the AS group, as expected (p<0.01). In the logistic regression analysis, albumin, CRP, low-density lipoprotein LDL, theCAR, and cCAR levels were found to be significantly and independently associated with the presence of AS (p<0.05). Moreover, in a regression analysis in the subgroup of AS only, albumin, the cCAR, and CAR were independently associated with the presence of very severe AS. Conclusion: Our study showed an important relationship between the CAR and AS. Therefore, in clinical practice, this simple, inexpensive, and practical method may predict the severity of AS.