Association between the red blood cell distribution width-albumin ratio and cardiovascular diseases.

BACKGROUND

Cardiovascular disease (CVD) is the major cause of death globally, ranking first in terms of morbidity and mortality among non-communicable diseases. Red blood cell distribution width (RDW) and albumin (ALB) possess potential clinical application values. Moreover, the ratio of the two, namely RAR, might hold more advantages in disease diagnosis. However, the relationship between RAR and CVD in the general population has not been studied yet.

METHOD

This represents a study encompassing 12,765 subjects. Logistic regression, Cox regression, restricted cubic splines, mediation analysis, and receiver operating characteristic curves were utilized to probe into the association between RAR and CVD, cardiovascular mortality rate and all-cause mortality rate.

RESULT

A total of 12,765 participants were enrolled in this study, The mean age was 47.47 ± 16.33 years. Logistic regression revealed that RAR was positively correlated with the CVD. Furthermore, COX regression also illustrated that RAR was non-linearly and positively associated with both all-cause mortality rate and cardiovascular mortality rate (all-cause mortality:  = 0.0322; cardiovascular mortality:  = 0.0280). Additionally, the ROC results indicated that at various time points, RAR exhibited a stronger discriminatory capacity for cardiovascular mortality rate compared to all-cause mortality rate. HbA1c partially mediated the relationship between RAR and CVD. Subgroup analysis and interaction findings demonstrated that hypertension and race exerted a significant influence on the relationship between RAR and both all-cause mortality rate and cardiovascular mortality rate.

CONCLUSION

RAR was significantly linked to an elevated risk of CVD. The higher the RAR level, the greater the cardiovascular mortality rate and all-cause mortality rate. Thus, RAR could potentially be an independent risk factor for CVD. This underscores the crucial value of RAR in the discrimination and management of CVD.