Acute heart failure patients with a high red blood cell distribution width-to-albumin ratio have an increased risk of all-cause mortality

Abstract

Background: Many studies have shown that specific blood markers, such as red cell distribution width (RDW) and albumin levels, can provide valuable information about the prognosis of patients with acute heart failure (AHF). In light of these findings, the current study aims to investigate the relationship between another blood marker, RDW to albumin ratio (RAR), and the prognosis of AHF patients. Methods: Data on patients diagnosed with AHF were extracted from the MIMIC-IV database version 2.1. Patients were divided into three groups based on RAR tertiles. Multiple imputation was used for missing data, and pooled analysis was performed for imputed data sets. This study used Cox regression analysis to evaluate the impact of RAR on Clinical Outcomes in AHF patients. To further assess the prognostic ability of RDW, RAR, and albumin, the study also used time-dependent receiver operating characteristic (time-ROC) analysis. Results: This study enrolled 1432 patients with AHF, with a mean age of 72.4 years and a mean RAR of 5.07 {plus minus} 1.51% /g/dl. Patients with AHF had increased all-cause mortality when their RAR was higher (HR = 1.16, 95% CI: 1.10 ~ 1.23, P < 0.001), and RAR and mortality from all causes were linearly related in patients with AHF (P non-linearity = 0.643). Based on time-ROC curves, it was discovered that RAR had a higher prognostic accuracy compared to RDW and albumin. Conclusions: An increased level of RAR was associated with a poor all-cause mortality prognosis for patients with AHF, and there is a significant linear relationship. RAR was a better predictor of all-cause mortality in AHF patients than RDW and albumin.