Association between red blood cell distribution width-to-albumin ratio and prognosis of patients with acute myocardial infarction

Abstract

Background Red blood cell distribution width (RDW) and albumin level were considered to be related to the prognosis of patients with acute myocardial infarction (AMI). This study aims to investigate the correlation between RAR and 90-day mortality in AMI patients. Methods Data of AMI patients were obtained from the Medical Information Mart for Intensive Care III (MIMIC-III) database. According to the median, RAR < 4.32 was regarded as low RAR level group, and RAR ≥ 4.32 as high RAR level group; low RDW level group was defined as < 14.00%, and high RDW level group as ≥ 14.00%; albumin < 3.30 g/dL was low level group, and albumin ≥ 3.30 g/dL as high level group. The outcome was the mortality rate within 90 days after admission to ICU. Univariate and multivariate Cox models were performed to determine the relationship between RAR and 90-day mortality in AMI patients with hazard ratio (HR) and 95% confidence interval (CI). Stratification analyses were conducted to explore the effect of RAR on 90-day mortality in different subgroups of age, gender, simplified acute physiology score II (SAPS II), elixhauser comorbidity index (ECI) score, treatment modalities and white blood cell. Results Of the total 2081 AMI patients, 543 (26.09%) died within 90-day follow-up duration. The results showed that high RAR (HR = 1.65, 95% CI 1.34–2.03) and high RDW levels (HR = 1.31, 95% CI 1.08–1.61) were associated with an increased risk of death in AMI patients, and that high albumin level was related to a decreased risk of death (HR = 0.77, 95%CI 0.64–0.93). The relationship of RAR level and the mortality of AMI patients was also observed in the subgroup analysis. Additionally, the finding indicated that RAR might be a more effective biomarker for predicting 90-day mortality of AMI patients than albumin, RDW. Conclusion RAR may be a potential marker for the prognostic assessment of AMI, and a high RAR level was correlated with increased risk of 90-day mortality of AMI patients.

Red blood cell distribution width to albumin ratio is linked to all-cause mortality in critically ill patients with acute kidney injury: a retrospective cohort study

“…The rate of erythrocyte destruction and the release of immature erythrocytes into the circulation are also increased by oxidative stress, consequently leading to an increase in RDW values. Serum albumin, a vital protein with anti-inflammatory, nutritional, and hematological characteristics, effectively suppresses platelet activation and aggregation [25]. Serum albumin is traditionally evaluated to assess the nutritional status of patients who are critically ill. Hypoproteinemia is regarded as a dependable indicator of prognosis in numerous critically ill patients with chronic conditions [26].…”

Red blood cell distribution width is a useful biomarker to predict bleeding and thrombosis risks in patients with immune thrombocytopenic purpura

“…Elevated RDW has been associated not only with vascular risks, but also with the prognosis and risks of complications of various cancers, such as breast, lung, and esophageal cancers [44][45][46][47][48]. Recently, RDW has been reported as a potentially useful biomarker to predict prognosis and complication risks in hematologic cancers, such as diffuse large B-cell lymphoma, primary central nervous system lymphoma, multiple myeloma and chronic myeloid leukemia [49][50][51][52][53].…”

Utilizing red blood cell distribution width (RDW) as a reliable biomarker to predict treatment effects after chimeric antigen receptor T cell therapy

“…For instance, in cardiovascular disease, vascular endothelial disorder causes elevated RDW [20][21][22][23]. Moreover, it has been reported that elevated RDW level is associated not only with vascular risks, but also prognosis of various cancers, such as breast cancer, lung cancer, and esophageal cancer [39][40][41][42][43][44]. However, the connection between RDW in hematological malignancy and cellular therapy has been unclear [45].…”