红细胞分布宽度与白蛋白比值与 80 岁以上房颤患者 28 天死亡率的关系。

Relationship between the Ratio of Red Cell Distribution Width to Albumin and 28-Day Mortality among Chinese Patients over 80 Years with Atrial Fibrillation.

机构信息

Department of Emergency, Ningbo No.2 Hospital, Ningbo, China,

QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.

出版信息

Gerontology. 2023;69(12):1471-1481. doi: 10.1159/000534259. Epub 2023 Oct 4.

DOI:10.1159/000534259

PMID:37793355

Abstract

INTRODUCTION

Atrial fibrillation (AF) is a prevalent heart arrhythmia in elderly adults aged 80 years or older. The red cell distribution width (RDW) to albumin ratio has been acknowledged as a reliable prognostic marker for poor outcomes in a variety of disorders. However, there exists limited scientific evidence on the association of RDW to albumin (RAR) with mortality in geriatric individuals with AF.

METHODS

From January 2015 to June 2020, a retrospective study was conducted in a tertiary academic institution that diagnosed 1,141 elderly adults with AF. The RAR value was calculated as the ratio of RDW (%) to albumin (g/dL). The potential association between RAR and cardiovascular mortality and the risk of all-cause mortality within 28 days was evaluated by means of multivariable Cox regression analysis.

RESULTS

The 28-day all-cause and cardiovascular mortality rates were 8.7% and 3.3%, respectively. Increased RAR tertiles were found to be significantly associated with greater all-cause mortality (T1: 1.6%; T2: 6.2%; T3: 18.1%, p < 0.001) and cardiovascular mortality (T1: 0.8%; T2: 2.9%; T3: 6.3%, p < 0.001) using Kaplan-Meier analysis. Continuous RAR had a positive association with all-cause mortality (hazard ratios [HR] = 1.42, 95% confidence interval [CI] 1.23-1.65) and cardiovascular mortality (HR = 1.31, 95% CI: 1.05-1.64), even after accounting for numerous confounding variables. In comparison to the T1 group, individuals with the highest RAR levels displayed a greater risk of all-cause mortality (HR = 2.73, 95% CI: 1.11-6.74) and cardiovascular mortality (HR = 2.59, 95% CI: 0.69-9.78). Increased RAR levels were related to higher rates of cardiovascular and all-cause mortality across almost all subgroups.

CONCLUSION

RAR is independently correlated with 28-day all-cause mortality and cardiovascular mortality in AF-affected individuals aged ≥80.

摘要

简介

心房颤动（AF）是 80 岁及以上老年人中常见的心律失常。红细胞分布宽度（RDW）与白蛋白比值已被认为是多种疾病不良预后的可靠预后标志物。然而，对于患有 AF 的老年个体，RDW 与白蛋白（RAR）与死亡率之间的关联的科学证据有限。

方法

本研究为回顾性研究，于 2015 年 1 月至 2020 年 6 月在一家三级学术机构中进行，共诊断出 1141 例老年 AF 患者。RDW 与白蛋白比值（RAR）值计算为 RDW（%）与白蛋白（g/dL）的比值。采用多变量 Cox 回归分析评估 RAR 与 28 天内全因死亡率和心血管死亡率的潜在关联。

结果

28 天全因和心血管死亡率分别为 8.7%和 3.3%。Kaplan-Meier 分析发现，较高的 RAR 三分位组与全因死亡率（T1：1.6%；T2：6.2%；T3：18.1%，p < 0.001）和心血管死亡率（T1：0.8%；T2：2.9%；T3：6.3%，p < 0.001）显著相关。连续 RAR 与全因死亡率（风险比[HR] = 1.42，95%置信区间[CI] 1.23-1.65）和心血管死亡率（HR = 1.31，95%CI：1.05-1.64）呈正相关，即使在考虑了众多混杂变量后也是如此。与 T1 组相比，RAR 水平最高的患者全因死亡率（HR = 2.73，95%CI：1.11-6.74）和心血管死亡率（HR = 2.59，95%CI：0.69-9.78）风险更高。几乎所有亚组中，RAR 水平升高与心血管和全因死亡率的发生率升高相关。