Higher red cell distribution width to albumin ratio (T3 vs T1) was significantly associated with increased 28-day all-cause mortality (HR 2.73; 95% CI 1.11-6.74) in AF patients aged ≥80 years.
Cohort (n=1,141)
No
Does a higher red cell distribution width to albumin ratio (RAR) predict increased 28-day mortality in Chinese patients aged ≥80 years with atrial fibrillation?
In patients aged ≥80 years with atrial fibrillation, a higher red cell distribution width to albumin ratio is independently associated with increased 28-day all-cause and cardiovascular mortality.
Effect estimate: HR 2.73 (95% CI 1.11-6.74)
Absolute Event Rate: 18.1% vs 1.6%
p-value: p=<0.001
INTRODUCTION: Atrial fibrillation (AF) is a prevalent heart arrhythmia in elderly adults aged 80 years or older. The red cell distribution width (RDW) to albumin ratio has been acknowledged as a reliable prognostic marker for poor outcomes in a variety of disorders. However, there exists limited scientific evidence on the association of RDW to albumin (RAR) with mortality in geriatric individuals with AF. METHODS: From January 2015 to June 2020, a retrospective study was conducted in a tertiary academic institution that diagnosed 1,141 elderly adults with AF. The RAR value was calculated as the ratio of RDW (%) to albumin (g/dL). The potential association between RAR and cardiovascular mortality and the risk of all-cause mortality within 28 days was evaluated by means of multivariable Cox regression analysis. RESULTS: The 28-day all-cause and cardiovascular mortality rates were 8.7% and 3.3%, respectively. Increased RAR tertiles were found to be significantly associated with greater all-cause mortality (T1: 1.6%; T2: 6.2%; T3: 18.1%, p < 0.001) and cardiovascular mortality (T1: 0.8%; T2: 2.9%; T3: 6.3%, p < 0.001) using Kaplan-Meier analysis. Continuous RAR had a positive association with all-cause mortality (hazard ratios HR = 1.42, 95% confidence interval CI 1.23-1.65) and cardiovascular mortality (HR = 1.31, 95% CI: 1.05-1.64), even after accounting for numerous confounding variables. In comparison to the T1 group, individuals with the highest RAR levels displayed a greater risk of all-cause mortality (HR = 2.73, 95% CI: 1.11-6.74) and cardiovascular mortality (HR = 2.59, 95% CI: 0.69-9.78). Increased RAR levels were related to higher rates of cardiovascular and all-cause mortality across almost all subgroups. CONCLUSION: RAR is independently correlated with 28-day all-cause mortality and cardiovascular mortality in AF-affected individuals aged ≥80.
Chen et al. (Sun,) conducted a cohort in Atrial fibrillation (n=1,141). Red cell distribution width to albumin ratio (RAR) vs. Lower RAR tertiles (T1) was evaluated on 28-day all-cause mortality (HR 2.73, 95% CI 1.11-6.74, p=<0.001). Higher red cell distribution width to albumin ratio (T3 vs T1) was significantly associated with increased 28-day all-cause mortality (HR 2.73; 95% CI 1.11-6.74) in AF patients aged ≥80 years.
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