Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Xueyuanxi Road, No.109, Wenzhou 325000, Zhejiang, China.
Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Xueyuanxi Road, No.109, Wenzhou 325000, Zhejiang, China.
Clin Chim Acta. 2022 Feb 15;527:38-46. doi: 10.1016/j.cca.2021.12.027. Epub 2021 Dec 31.
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 < 0.0001). A similar trend was observed for 30-day, one-year mortality. For HF patients, high RAR significantly increased the risk of sepsis and requirement for renal replacement therapy. Additionally, there is a positive correlation between RAR, CRP levels, and NT-proBNP respectively.
High level of RAR is associated with increased short- and long-term mortality of patients with heart failure. The RAR is a promising biomarker that is easy to obtain and readily predicts mortality in heart failure patients.
流行病学研究表明，红细胞分布宽度（RDW）的增加和白蛋白水平的降低可以独立预测心血管不良结局。RDW-白蛋白比值（RAR）作为一种新的炎症标志物，其在心力衰竭（HF）患者中的预后价值尚未得到评估。本研究旨在探讨 RAR 与 HF 患者死亡率之间的关系。
从 MIMIC-III 数据库版本 1.4 中提取诊断为 HF 的患者数据。使用 Cox 比例风险模型来研究 RAR 与 HF 患者死亡率之间的关系。还招募了温州医科大学第二附属医院的 HF 患者，以探讨 RAR 与 HF 现有指标之间的关系。
对于 90 天死亡率，第二（4.33＜RAR＜5.44）和第三（RAR＞5.44）三分位组的 HR（95%CI）分别为 2.00（1.58，2.54）和 3.63（2.91，4.53），与第一三分位组（RAR＜4.33）相比。在模型 1 中调整年龄、性别和种族后，第三三分位组的调整 HR（95%CI）值为 3.66（2.93，4.56）。在模型 2 中进一步调整生命体征、血液生化指标、SOFA 评分和其他参数后，第三三分位组的调整 HR 值仍然具有统计学意义（HR：2.70，95%CI：2.07-3.51，P＜0.0001）。对于 30 天和 1 年死亡率，也观察到了类似的趋势。对于 HF 患者，高 RAR 显著增加了脓毒症和需要肾脏替代治疗的风险。此外，RAR 与 CRP 水平和 NT-proBNP 之间呈正相关。
高水平的 RAR 与心力衰竭患者短期和长期死亡率的增加有关。RAR 是一种很有前途的易于获得的生物标志物，可很好地预测心力衰竭患者的死亡率。
