The Ratio of Red Blood Cell Distribution Width to Albumin Is Correlated With All-Cause Mortality of Patients After Percutaneous Coronary Intervention – A Retrospective Cohort Study

Abstract

ObjectivesThe purpose of this study was to investigate the independent effect of the ratio of red blood cell distribution width (RDW) to albumin (RA) on all-cause mortality in patients after percutaneous coronary intervention (PCI).MethodsClinical data were obtained from the Multiparameter Intelligent Monitoring in Intensive Care-III (MIMIC-III) database version 1.4 and the database of Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University. We used the MIMIC-III database for model training, and data collected from the Second Affiliated Hospital of Wenzhou Medical University for validation. The primary outcome of our study was 90-day mortality. Cox proportional hazards regression model was used to estimate hazard ratio (HR) for the association between RA and all-cause mortality in patients after PCI. Pearson correlation analysis was conducted to assess the relationship between RA and Gensini score or cardiac troponin I (cTnI).ResultsA total of 707 patients were eligible in MIMIC-III database, including 432 males, with a mean age of 70.29 years. For 90-day all-cause mortality, in the adjusted multivariable model, the adjusted HRs [95% confidence intervals (CIs)] for the second (RA: 3.7–4.5 ml/g) and third (RA >4.5 ml/g) tertiles were 2.27 (1.11, 4.64) and 3.67 (1.82, 7.40), respectively, compared to the reference group (RA <3.7 ml/g) (p < 0.05). A similar relationship was also observed for 30-day all-cause mortality and 1-year all-cause mortality. No significant interaction was observed in subgroup analysis. Receiver operating characteristic (ROC) curve analysis proved that the ability of RA to predict the 90-day mortality was better than that of RDW or albumin alone. The correlation coefficient between Gensini score and RA was 0.254, and that between cTnI and RA was 0.323.ConclusionRA is an independent risk factor for all-cause mortality in patients after PCI. The higher the RA, the higher the mortality. RA has a good predictive ability for all-cause mortality in patients after PCI, which is better than RDW or albumin alone. RA may be positively correlated with the severity of coronary artery disease (CAD) in patients with CAD.

Association between red blood cell distribution width to albumin ratio and prognosis of patients with sepsis: A retrospective cohort study

“…This can be explained as follows. Although both RDW and albumin are associated with sepsis (38), which is similar to the result of this study. In addition, we observed that the area under the ROC curve increased after RAR was combined with SAPS II score or SOFA score, suggesting that RAR combined with SAPS II or SOFA score further improves the predictive power of septic mortality.…”

Relationship between red cell distribution width/albumin ratio and carotid plaque in different glucose metabolic states in patients with coronary heart disease: a RCSCD-TCM study in China

“…Weng et al believed that RAR had a better predictive ability for all-cause mortality of patients after PCI, and was superior to RDW or ALB alone. The RAR of patients with CHD may be positively correlated with the severity of CAD [ 44 ]. The rupture of atherosclerotic plaque and subsequent thrombosis are the main causes of acute cardiovascular events [ 27 ].…”

Red blood cell distribution width/albumin ratio is a novel risk factor of incidence and long-term mortality in chronic heart failure patients: three large cohorts from China and America

“…As an inflammation-related indicator[28], RAR received increasing attention[29–31] in recent years. However, RAR was only utilized for the short-term prognosis in diseases (30 days[30], 90 days[15, 16], 1 year[32]). For example, RAR was closely related to the incidence of contrast-related renal injury[28] and diabetic retinopathy[33].…”