Kanzaki Yusuke, Minamisawa Masatoshi, Motoki Hirohiko, Suzuki Sho, Okuma Yukari, Kanai Masafumi, Machida Keisuke, Kimura Kazuhiro, Ueki Yasushi, Yoshie Koji, Oguchi Yasutaka, Kato Tamon, Saigusa Tatsuya, Ebisawa Soichiro, Okada Ayako, Kuwahara Koichiro
Department of Cardiovascular Medicine, Shinshu University School of Medicine, Japan.
Intern Med. 2025 Mar 15;64(6):807-816. doi: 10.2169/internalmedicine.3691-24. Epub 2024 Aug 10.
Objective The ratio of hemoglobin to red blood cell distribution width (Hb/RDW) is a simple and readily available tool associated with adverse outcomes in chronic heart failure (HF). However, the association between the Hb/RDW ratio and mortality in patients with acute decompensated HF (ADHF) is unclear. The goal of this study was to investigate the relationship between the Hb/RDW ratio and mortality in patients after ADHF. Methods This single-center study included clinical and laboratory data collected at baseline, with patients prospectively followed-up for a median period of 3.1 years. The patients were divided into two groups based on their median Hb/RDW ratio. Patients We evaluated 250 consecutive patients hospitalized for ADHF at Shinshu University Hospital between July 2014 and March 2019. Results In our study cohort [median age, 76 (66-83) years; 62.8% male], all-cause death was observed in 91 patients (incidence rate: 12.7 per 100 patient-years). A Kaplan-Meier analysis revealed that patients in the lower Hb/RDW ratio group (<0.24, n=131) had worse outcomes compared to those in the higher group (≥0.24, n=119) (cumulative incidence 44.1% vs. 19.5%, respectively; log-rank, p<0.001). After adjusting for demographics, HF severity, and laboratory biomarkers, a lower Hb/RDW ratio was significantly associated with a higher risk of mortality (hazard ratio, 1.89; 95% confidence interval, 1.04-3.45; p=0.038). Conclusion A lower Hb/RDW ratio is associated with an increased risk of mortality in patients after ADHF, thus indicating its potential utility in identifying patients at an elevated risk for future cardiovascular events.
目的 血红蛋白与红细胞分布宽度之比（Hb/RDW）是一种简单且易于获得的指标，与慢性心力衰竭（HF）的不良预后相关。然而，Hb/RDW比值与急性失代偿性心力衰竭（ADHF）患者死亡率之间的关联尚不清楚。本研究的目的是探讨ADHF患者Hb/RDW比值与死亡率之间的关系。方法 这项单中心研究纳入了基线时收集的临床和实验室数据，对患者进行了为期3.1年的前瞻性随访。根据患者的Hb/RDW比值中位数将其分为两组。患者 我们评估了2014年7月至2019年3月期间在信州大学医院因ADHF住院的250例连续患者。结果 在我们的研究队列中[中位年龄，76（66 - 83）岁；62.8%为男性]，91例患者发生全因死亡（发病率：每100患者年12.7例）。Kaplan-Meier分析显示，Hb/RDW比值较低组（<0.24，n = 131）的患者预后比Hb/RDW比值较高组（≥0.24，n = 119）的患者差（累积发病率分别为44.1%和19.5%；对数秩检验，p<0.001）。在调整了人口统计学、HF严重程度和实验室生物标志物后，较低的Hb/RDW比值与较高的死亡风险显著相关（风险比，1.89；95%置信区间，1.04 - 3.45；p = 0.038）。结论 较低的Hb/RDW比值与ADHF患者死亡风险增加相关，这表明其在识别未来心血管事件风险升高患者方面具有潜在效用。
