This study aimed to investigate if the ratio of uric acid to albumin (UAR) correlates with all-cause mortality. Smooth curve fitting was employed to analyze the association between UAR and all-cause mortality; a threshold saturation effect model was utilized to identify the inflection point of UAR’s impact on all-cause mortality. Furthermore, the association between UAR and all-cause mortality from heart disease was assessed using a competing risks model. This study included 25,437 male participants and 27,090 female participants. Smooth curves fitting revealed a U-shaped relationship, demonstrating a distinct inflection point for UAR and all-cause mortality, with the inflection point for females appearing earlier than for males. Kaplan-Meier curves indicated a significantly elevated risk of death in the high UAR group (1.49 < UAR < 4.65) compared to the low UAR group (0 < UAR < 1.03). UAR emerges as a robust independent prognostic indicator for all-cause mortality and could serve as a readily accessible and valuable novel inflammatory marker for identifying high-risk patients.

To compare the effects of early angiotensin receptor-neprilysin inhibitor (ARNI) versus angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (ACEI/ARB) therapy on left ventricular remodeling and heart failure progression in patients with acute anterior wall myocardial infarction. Patients were stratified by treatment into ARNI (n = 97) and ACEI/ARB (n = 71) groups. Baseline characteristics, cardiac ultrasound data (baseline, 0-3 months, 6-12 months), and major adverse cardiac events (MACEs) were analyzed. The ARNI group demonstrated significantly greater improvements in left ventricular end-diastolic diameter and relative wall thickness versus the ACEI/ARB group. Subgroup analyses (target-dose achievers, emergency reperfusion recipients, left ventricular ejection fraction ≥50 % patients) consistently showed better improvements with ARNI. ARNI therapy also significantly reduced MACEs risk (HR = 0.392, 95 % CI: 0.194-0.791, P = 0.009). Compared with ACEI/ARB, ARNI demonstrated enhanced preservation of cardiac function, attenuation of adverse ventricular remodeling, and maintenance of ventricular geometry following myocardial infarction. Additionally, ARNI was associated with a reduction in major adverse cardiac events and improved survival outcomes.