Serum uric acid/creatinine ratio provides insights into the severity of coronary artery lesions and emerges as a potential predictor

Background: With changes in lifestyle, the incidence of chronic metabolic diseases and cardiovascular diseases has increased year by year, posing a major public health threat to human health. Coronary heart disease (CHD) is one of the most common cardiovascular diseases in clinical practice, with its mortality rate consistently ranking among the highest globally. Therefore, timely and accurate assessment of coronary artery lesions play a crucial role in reducing mortality and improving prognosis in CHD patients. Objective: To investigate the correlation between the serum uric acid-to-creatinine ratio (SUA/Scr) and the severity of coronary artery disease, and to evaluates its potential clinical value in predicting disease severity and risk stratification. This study aims to provide experimental evidence and theoretical support for early warning, disease assessment, and the development of individualized prevention and treatment strategies for CHD. Methods: This retrospective study included 528 patients with CHD who underwent initial coronary angiography due to chest pain or chest tightness at the Department of Cardiovascular Medicine, Mianyang Third People's Hospital, from January and December 2023. Gensini scores were calculated based on coronary angiography results, and patients were divided into three groups: mild lesion group (Gensini score < 20, n=156), moderate lesion group (20 ≤ Gensini score < 40, n=155), and severe lesion group (Gensini score ≥ 40, n=217). General clinical data and biochemical indicators were collected, and the SUA/Scr ratio were calculated. Differences in SUA, Scr, and SUA/Scr among the three groups were compared. Multivariate ordinal logistic regression analysis was used to identify independent risk factors for coronary lesions. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive efficacy of SUA, Scr, and SUA/Scr for moderate-to-severe coronary lesions. Results: Intergroup comparisons showed no significant difference in Scr levels among the three groups ( P > 0.05). No significant difference in SUA levels was observed between the mild and moderate lesion groups ( P > 0.05); however, SUA levels in both groups were significantly lower than those in the severe lesion group (both P < 0.05). In contrast, the SUA/Scr ratio progressively increased with the severity of coronary lesions, and pairwise comparisons among the three groups (all P < 0.05). Multivariate binary logistic regression analysis revealed that, after adjusting for confounding factors, SUA/Scr ratio remained an independent risk factor for severe coronary lesions, with OR=101.844, P < 0.05. ROC curve analysis showed that the area under the curve (AUC), optimal cutoff value, sensitivity, and specificity of SUA/Scr were 0.840, 5.35, 80.60%, and 75.2%, respectively—values that were all higher than those obtained when SUA or Scr was used individually. Conclusion: SUA/Scr ratio is closely associated with the severity of coronary artery lesions in CHD patients and serves as an independent predictor of coronary artery disease, holding significant clinical value in assessing the severity of coronary lesions.