AIM   To investigate the clinical value of serum C-reactive protein/albumin ratio (CRP/ALB, CAR) and neutrophil/high-density lipoprotein ratio (NE/HDL, NHR) in predicting the degree of coronary artery disease.

  METHODS  A total of 638 patients who underwent coronary angiography in the Department of Cardiology of Hefei Second People’s Hospital from January 2019 to December 2021 were retrospectively analyzed. According to their angiography results, the patients were divided into a coronary heart disease group (CHD, n=397) and a control group (n=241) and according to Gensini scores (GS), the coronary heart disease group was subdivided into severe lesion group (GS≥40, n=164) and a mild lesion group (GS<40, n=233). The differences in CAR and NHR were compared between the groups. Spearman analysis was used to test the correlation between CAR, NHR and GS, logistic regression was used to screen the independent factors of coronary heart disease and severe coronary lesions, and ROC curve was used to analyze the value of CAR, NHR and their combination in predicting multi-vessel disease.

  RESULTS  CAR and NHR in CHD group were higher than those in control group, CAR and NHR in severe lesion group were higher than those in mild lesion group (P<0.01). Spearman correlation analysis showed that CAR and NHR were positively correlated with GS (r_car=0.422, r_nhr=0.506, P<0.01). ROC analysis showed that CAR, NHR and their combination had predictive value for multi-vessel disease, the area under the curve (AUC) of their combination was larger and the predictive efficiency was higher than those of a single index (P<0.05).

  CONCLUSION  CAR and NHR can be used as independent predictors of the severity of coronary artery disease and can be used in the diagnosis and evaluation of coronary heart disease.