Prognostic Value of The Uric Acid-To-Albumin Ratio for Mıd-Term All-Cause Mortality After Carotid Artery Stenting

Purpose: Carotid artery stenting (CAS) is an established revascularization strategy, particularly in high-risk surgical patients. The uric acid-to-albumin ratio (UAR) has recently emerged as a novel composite biomarker reflecting oxidative stress, systemic inflammation, and nutritional status. This study evaluated the prognostic significance of UAR in predicting mid-term all-cause mortality following CAS. Methods: In this retrospective cohort study, 970 consecutive patients undergoing CAS at a tertiary cardiovascular center between 2015 and 2024 were analyzed. The primary endpoint was mid-term all-cause mortality. Patients were stratified into Low UAR (<1.475) and High UAR (≥1.475) groups based on the median UAR. Survival analyses were performed using Cox proportional hazards models to identify independent predictors of mortality. Results: The median follow-up was 33.7 ± 26.5 months. Overall, 154 patients (15.9%) died, with mortality significantly higher in the High UAR group compared with the Low UAR group [19.0% (n=92) vs. 12.8% (n=62); p=0.008]. In multivariable analysis, elevated neutrophil count (HR: 1.68; 95% CI: 1.25–2.25; p=0.001) and UAR (HR: 1.69; 95% CI: 1.24–2.30; p=0.001) independently predicted mid-term mortality. Conclusions: Elevated UAR is independently associated with increased all-cause mortality after CAS. UAR may facilitate risk stratification and prognostic assessment in this high-risk population.