The red blood cell distribution width-albumin ratio: A promising predictor of mortality in heart failure patients — A cohort study

• Published in: Clinica chimica acta 2022-02, Vol.527, p.38-46
• Main Authors: Ni, Qingwei, Wang, Xue, Wang, Jie, Chen, Peng
• Format: Article
• Language: English
• Subjects: Albumins; Cohort Studies; Erythrocyte Indices; Erythrocytes; Heart failure; Heart Failure - diagnosis; Humans; Inflammation; Prognosis; Red blood cell distribution width-albumin ratio
• ISSN: 0009-8981; 1873-3492
• DOI: 10.1016/j.cca.2021.12.027

Epidemiological studies suggest that increases in red blood cell distribution width (RDW) and decreases in albumin level can independently predict adverse cardiovascular outcomes. The prognostic value of RDW-albumin ratio (RAR), an innovate biomarker of inflammation, in heart failure (HF) patients has not been assessed. This study aimed to explore the association between RAR and mortality of HF patients. Data on patients diagnosed with HF were extracted from MIMIC-III database version 1.4. Cox proportional hazards models were used to investigate the associations between RAR and mortality of HF patients. HF patients admitted to the Second Affiliated Hospital of Wenzhou Medical University were also enrolled to explore the relationship between RAR and existing indicators of HF. For 90-day mortality, the HR (95% CI) for the second (4.33＜RAR＜5.44) and the third (RAR＞5.44) tertiles were 2.00 (1.58, 2.54) and 3.63 (2.91, 4.53), respectively, compared to the first tertile (RAR＜4.33). When adjusted for age, gender and ethnicity in Model 1, the adjusted HR (95% CI) value of third tertiles was 3.66 (2.93, 4.56). Further adjust the vital signs, blood biochemical indicators, SOFA score and other parameters in Model II, the adjusted HR value of third tertiles was still statistically significant (HR: 2.70, 95% CI: 2.07–3.51, P