RDW-CV/albumin ratio (RAR) >4.3 predicts short-term ICU admission or death after PCI in STEMI with OR 3.81 (95% CI 2.3-6.1), superior to other blood cell ratios.
Does the RDW-CV/albumin ratio (RAR) predict short-term outcomes better than other blood cell ratios in patients presenting with STEMI undergoing PCI?
The RDW-CV/albumin ratio (RAR) is a superior predictor of short-term adverse outcomes compared to other blood-derived ratios in STEMI patients undergoing PCI, which may aid in early risk stratification.
Absolute Event Rate: 0% vs 0%
Abstract Background Evidence for RAR as a predictor of mortality in patients who undergo PCI has been demonstrated but not deployed as a standard tool for early risk stratification of this population. We compared RAR to other evidence-based blood cell derived ratios as predictors of short-term outcomes. Primary endpoint was ICU admission, hospital death, or hospice discharge in patients presenting with STEMI who underwent PCI. Methods Under IRB exception, demographics, and laboratory results within 6 hours of presentation were extracted from electronic medical records identified with ICD-10 codes. Univariate logistic regression identified comorbidities and blood cell ratios associated (p.05) with PCI while computing odds ratio with 95% confidence intervals. Youden’s Index identified cut points of ratios. Continuous data summarized as mean were compared using ANOVA test. Discrete data summarized as proportions were compared with chi-squared test. Results Among 716 patients studied, 104 (15%) met the composite outcome and 612 (85%) did not, respectively aged 70±14 vs. 67±12 years (p=0.008) distribute across males (67% vs. 73%, p=0.24). Odds ratio 95% CI for ratio cut points included RAR at 4.3 and 3.81 (2.3, 6.1) p0.0001, Systemic Immune-Inflammation Index at 1794 and 2.6 (1.62, 4.18) p0.0002, Neutrophil/Lymphocyte Ratio at 6.52 and 2.53 (1.60, 3.99) p0.0002, WBC /Platelet Ratio at 0.058 and 2.8 (1.79, 4.40) p0.0001. Heart failure and pulmonary circulation disorders demonstrated higher odds of experiencing composite outcome 5.11 (3.2, 7.9) p0.0001 and 5.10 (2.2, 11.7) p0.0003 respectively. Conclusion RAR is superior as a predictor of short-term outcomes in patients with STEMI undergoing PCI compared to other blood derived ratios. Standard utilization may aid patient triaging, identification of comorbidities and prompt treatment to avoid progression to severe disease course.Odds ratios for composite outcome
Espinal et al. (Sat,) reported a other. RDW-CV/albumin ratio (RAR) >4.3 predicts short-term ICU admission or death after PCI in STEMI with OR 3.81 (95% CI 2.3-6.1), superior to other blood cell ratios.