The First Clinical College, 74738Shandong Chinese Medical University, Ji Nan, People's Republic of China.
Department of Cardiovascular Medicine, 159393The First Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, People's Republic of China.
Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221121286. doi: 10.1177/10760296221121286.
Red blood cell distribution width (RDW) was a risk factor for poor prognosis in acute myocardial infarction (AMI). Recent reports suggested that combining RDW with other laboratory metrics could provide a better prediction. This retrospective study aimed to investigate whether the RDW-albumin ratio (RAR) may be associated with mortality after an AMI.
This cohort study was conducted among adults (over 16 years old) with AMI in the Medical Information Mart for Intensive Care Database III V1.4 (MIMIC-III). The primary outcome was 30-day mortality, and the secondary outcome was 1-year and 3-year mortality. Cox hazard regression model and Kaplan-Meier survival curves were constructed to estimate the effect of biomarkers on mortality. We used three models to adjust for potential bias. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were analyzed for the excellent performance of RAR on prognosis.
A total of 826 patients were eventually enrolled in our study. In multivariate analysis, RAR was found to be associated with 30-day mortality (Model 3: HR = 1.23, 95% CI = 1.09-1.39, < .001). In addition, Subgroup analysis showed that the effect of RAR was higher in female patients than in male patients ( for interaction = .026). Kaplan-Meier survival curves showed that patients in the lower RAR quartile tended to have higher survival rates in the short and long term. AMI patients with RAR ≥ 4 had a 122% increase in 3-year mortality. Results of ROC and AUC showed that the prognostic performance of RAR for mortality was the best (30-day mortality: 0.703; 1-year mortality: 0.729; 3-year mortality: 0.737).
RAR is a simple and stable predictor of prognosis in AMI patients. Our results support RAR = 4.0 as a criterion for prognostic risk stratification of AMI patients.
红细胞分布宽度（RDW）是急性心肌梗死（AMI）预后不良的危险因素。最近的报告表明，将 RDW 与其他实验室指标相结合可以提供更好的预测。本回顾性研究旨在探讨 RDW-白蛋白比值（RAR）是否与 AMI 后的死亡率相关。
本队列研究在 Medical Information Mart for Intensive Care Database III V1.4（MIMIC-III）中进行，纳入了年龄在 16 岁以上的 AMI 成年患者。主要结局为 30 天死亡率，次要结局为 1 年和 3 年死亡率。构建 Cox 风险回归模型和 Kaplan-Meier 生存曲线来估计生物标志物对死亡率的影响。我们使用了三个模型来调整潜在的偏倚。分析了 ROC 曲线和曲线下面积（AUC），以评估 RAR 对预后的优异性能。
共有 826 名患者最终纳入本研究。多变量分析显示，RAR 与 30 天死亡率相关（模型 3：HR=1.23，95%CI=1.09-1.39，<.001）。此外，亚组分析显示，RAR 的作用在女性患者中高于男性患者（交互项=0.026）。Kaplan-Meier 生存曲线显示，RAR 较低四分位患者在短期和长期内的生存率较高。RAR≥4 的 AMI 患者的 3 年死亡率增加了 122%。ROC 和 AUC 的结果表明，RAR 对死亡率的预后性能最佳（30 天死亡率：0.703；1 年死亡率：0.729；3 年死亡率：0.737）。
RAR 是 AMI 患者预后的简单且稳定的预测指标。我们的结果支持 RAR=4.0 作为 AMI 患者预后风险分层的标准。
