Objective: To evaluate the prognosticvalue of the uric acid-to-albumin ratio (UAR) for predicting major adverse cardiovascular and cerebrovascular events (MACCE) after carotid artery stenting (CAS). Methods: A total of 332 patients who underwent CAS were retrospectively enrolled in the study. For each patient, the uric acid level was divided by the corresponding serum albumin level to calculate the UAR. Patients were followed up for the occurrence of MACCE. The association between UAR and MACCE was analyzed to determine its predictive value. Results: Patients were followed up for an average of 45.30 +/- 27.26 months. Those who experienced MACCE were significantly older and were more likely to have undergone prior carotid endarterectomy. Additionally, they exhibited elevated serum creatinine and uric acid levels. In contrast, serum albumin and hemoglobin levels were significantly lower in the MACCE group. Furthermore, patients who developed MACCE had longer lesion lengths, required longer stents, and experienced higher rates of periprocedural stroke and in-hospital mortality. Multivariable logistic regression analysis identified a history of endarterectomy, elevated serum creatinine levels, and higher UAR as independent predictors of MACCE. Conclusion: Higher UAR values were significantly associated with increased risk of adverse outcomes. These findings suggest that UAR may serve as a simple, accessible, and cost-effective biomarker for risk stratification and prognosis in patients undergoing CAS.
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