{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T18:01:27Z","timestamp":1785175287532,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Preclinical heart failure (PHF) is an early stage in the heart failure continuum, yet practical indices for mortality risk assessment remain understudied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis<\/jats:title>\n                    <jats:p>The C\u2010reactive protein\u2013albumin\u2013lymphocyte index (CALLY), red cell distribution width\u2013albumin ratio (RAR), and blood urea nitrogen\u2013albumin ratio (BAR) are associated with mortality and provide additional predictive information among adults with PHF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed adults aged \u2265\u200920 years with PHF from the National Health and Nutrition Examination Survey (NHANES) 1999\u20132010. PHF was defined by hypertension, diabetes, obesity, atherosclerotic cardiovascular disease, or prior myocardial infarction, without diagnosed heart failure. The indices were derived from baseline laboratory measurements and log\u2010transformed. Mortality was ascertained through December 31, 2019. Associations were assessed using survey\u2010weighted Cox models; nonlinearity, subgroup consistency across different PHF compositions, incremental predictive performance, and sensitivity analyses, including competing\u2010risk models, were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 14\u2009717 adults with PHF contributing 186\u2009678.5 person\u2010years, 3801 all\u2010cause and 1226 cardiovascular deaths occurred. Per standard deviation increase, ln CALLY was associated with lower all\u2010cause and cardiovascular mortality (HRs, 0.85 and 0.87), whereas ln RAR (HRs, 1.28 and 1.24) and ln BAR (HRs, 1.09 and 1.18) were associated with higher mortality. ln RAR showed the most consistent improvement in exploratory incremental predictive performance beyond the base model. The directions of association were broadly consistent across different PHF compositions, and the findings remained robust in sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CALLY, RAR, and BAR were independently associated with mortality in adults with PHF; RAR may improve mortality risk assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70401","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T12:45:49Z","timestamp":1783341949000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of the C\u2010Reactive Protein\u2212Albumin\u2212Lymphocyte Index, Red Cell Distribution Width\u2212Albumin Ratio, and Blood Urea Nitrogen\u2212Albumin Ratio With All\u2010Cause and Cardiovascular Mortality Among Adults With Preclinical Heart Failure"],"prefix":"10.1002","volume":"49","author":[{"given":"Huifang","family":"Su","sequence":"first","affiliation":[{"name":"Ganzhou People's Hospital Ganzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7977-8919","authenticated-orcid":false,"given":"Xiandong","family":"Liu","sequence":"additional","affiliation":[{"name":"Ganzhou People's Hospital Ganzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2115"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2021.01.022"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvac013"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.14857"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2025.03.018"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.14461"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1237729"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/00033197221120135"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-024-01024-y"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2023.101911"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2025.1410339"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2021.12.027"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.13825"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-16383-w"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2021.06.414"},{"issue":"56","key":"e_1_2_13_17_1","first-page":"1","article-title":"National Health and Nutrition Examination Survey: Plan and Operations, 1999\u20132010","volume":"1","author":"Zipf G.","year":"2013","journal-title":"Vital and Health Statistics. 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