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The relationship between hemoglobin to red cell distribution width (RDW) ratio (HRR) and prognosis in patients with acute coronary syndrome

Year 2024, Volume: 5 Issue: 4, 188 - 192, 29.08.2024
https://doi.org/10.47582/jompac.1506991

Abstract

Aims: The use of hematological parameters in the prognostic assessment of acute coronary syndrome (ACS) has become common in recent years. Thus, our study aimed to evaluate the relationship between hemoglobin to red cell distribution width (RDW) ratio (HRR) and prognosis of these patients.
Methods: A retrospective evaluation was conducted on patients who presented to the emergency department between 01.09.2023 and 01.04.2024 and received a diagnosis of ACS. HRR was determined by dividing the hemoglobin concentration by the red cell distribution width (RDW). The patients were categorized into two groups based on their HRR values: high HRR patients and low HRR patients, using a specified HRR cut-off value. Statistical comparisons were conducted on all parameters between the two patient groups. The variables potentially linked to mortality were analyzed using receiver operating characteristic (ROC) analysis.
Results: The in-hospital mortality rate, vasopressor needs, and MV support requirements were significantly higher in the low HRR (≤0.828) group than in the high HRR (>0.828) group (p<0.05 for all). The ROC analysis revealed that the HRR cut-off value for predicting mortality was 0.828. The sensitivity was determined to be 78.8% and the specificity was 92.5% (AUC: 0.885, p<0.001).
Conclusion: In patients with ACS, HRR measured at admission is a marker with a high prognostic value

Ethical Statement

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Thanks

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References

  • Xiu WJ, Zheng YY, Wu TT, et al. Hemoglobin-to-red-cell distribution width ratio is a novel predictor of long-term patient outcomes after percutaneous coronary intervention: a retrospective cohort study. Front Cardiovasc Med. 2022;16(9): 726025.
  • Kılıç O, Mustu M, Suygun H, Con E, Karakurt A, Fatma S. Hemoglobin/red cell distribution width ratio is associated with poor prognosis in patients with acute coronary syndrome in long-term follow-up. Int J Cardiovasc Sci. 2024;37(1):20230099.
  • Aktas G, Tel BA, Duman TT. Inflammatory indices derived from hemogram as prognostic markers of cardiovascular outcome. Int J Cardiovasc Sci. 2024;37(1):20240012.
  • Huo LK, Chen KY, Tse G, Liu T. Association of inflammatory markers based on routine blood with prognosis in patients underwent percutaneous coronary intervention. Medicine. 2024; 103(19):38118.
  • Li D, Ruan Z, Wu B. Association of red blood cell distribution width-albumin ratio for acute myocardial infarction patients with mortality: a retrospective cohort study. Clin Appl Thromb Hemost. 2022;28(1):10760296221121286.
  • Jian L, Zhang Z, Zhou Q, Duan X, Ge L. Red cell distribution width/albumin ratio: a predictor of in-hospital all-cause mortality in patients with acute myocardial infarction in the ICU. Int J Gen Med. 2023;27(16):745-756.
  • Huang S, Zhou Q, Guo N, et al. Association between red blood cell distribution width and in-hospital mortality in acute myocardial infarction. Medicine. 2021;100(15):25404.
  • Leonardi S, Gragnano F, Carrara G, et al. Prognostic implications of declining hemoglobin content in patients hospitalized with acute coronary syndromes. J Am Coll Cardiol. 2021;77(4):375-388.
  • Qin Z, Liao N, Lu X, Duan X, Zhou Q, Ge L. Relationship between the hemoglobin-to-red cell distribution width ratio and all-cause mortality in ischemic stroke patients with atrial fibrillation: an analysis from the MIMIC-IV database. Neuropsychiatry Dis Treat. 2022;18(18):341-354.
  • Wang J, Chen Z, Yang H, Li H, Chen R, Yu J. Relationship between the hemoglobin-to-red cell distribution width ratio and all-cause mortality in septic patients with atrial fibrillation: based on propensity score matching method. J Cardiovasc Dev Dis. 2022;9(11):400.
  • Qu J, Zhou T, Xue M, et al. Correlation analysis of hemoglobin-to-red blood cell distribution width ratio and frailty in elderly patients with coronary heart disease. Front Cardiovasc Med. 2021; 27(8):728800.
  • Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720-3826.
  • Ababneh MJ, Smadi MM, Al-Kasasbeh A, et al. Validity of TIMI risk score and heart score for risk assessment of patients with unstable angina/ non-st elevation myocardial infarction presented to an emergency department in Jordan. Open Access Emerg Med. 2023;18(15):465-471.
  • Salimi A, Zolghadrasli A, Jahangiri S, et al. The potential of HEART score to detect the severity of coronary artery disease according to SYNTAX score. Sci Rep. 2023;13(1):7228.
  • Rostami A, Tajlil A, Separham A, et al. Association between neutrophil-to-lymphocyte ratio and the systemic inflammatory immunologic index and the angiographic SYNTAX score and the TIMI flow grade in acute STEMI: a cohort study. J Tehran Heart Cent. 2021;16(4):147-155.
  • Li N, Zhou H, Tang Q. Red blood cell distribution width: a novel predictive indicator for cardiovascular and cerebrovascular diseases. Dis Markers. 2017;17(20):7089493.
  • Khaki S, Mortazavi SH, Bozorgi A, Sadeghian S, Khoshnevis M, Mahmoodian M. Relationship between red blood cell distribution width and mortality of patients with acute myocardial infarction referring to TEHRAN heart center. Crit Pathw Cardiol. 2015;14 (33):112-115.
  • Wei J, Yang RX, Ye Q, et al. Higher risk of myocardial injury in chest pain patients with elevated red blood cell distribution width. Clin Chim Acta. 2018;481(1):121-125.
  • Ishigami J, Grams ME, Naik RP, et al. Hemoglobin, albuminuria, and kidney function in cardiovascular risk: the ARIC (atherosclerosis risk in communities) study. J Am Heart Assoc. 2018;7(2):007209.
  • Uyarel H, Ergelen M, Cicek G, et al. Red cell distribution width as a novel prognostic marker in patients undergoing primary angioplasty for acute myocardial infarction. Coron Artery Dis. 2011;22(3):138-144.
  • Ndrepepa G, Neumann FJ, Menichelli M, et al. Prognostic value of hemoglobin drop in patients with acute coronary syndromes. Eur J Clin Invest. 2021;51(12):13670.
  • Bozkaya Y, Kurt B, Gürler F. A prognostic parameter in advanced non-small cell lung cancer: The ratio of hemoglobin-to-red cell distribution width. Int J Clin Oncol. 2019;24(7):798-806.
  • Yılmaz A, Mirili C, Tekin SB, Bilici M. The ratio of hemoglobin to red cell distribution width predicts survival in patients with gastric cancer treated by neoadjuvant FLOT: a retrospective study. Ir J Med Sci. 2020;189(1):91-102.
  • Song J, Yu T, Yan Q, Zhang Q, Wang L. Association of hemoglobin to red blood cell distribution width-standard deviation (RDW-SD) ratio and 3-month readmission in elderly chinese patients with heart failure:a retrospective cohort study. Int J Gen Med. 2023;24(16):303-315.

Akut koroner sendromlu hastalarda hemoglobin to red cell distribution width (RDW) ratio (HRR)’nın prognozla ilişkisi

Year 2024, Volume: 5 Issue: 4, 188 - 192, 29.08.2024
https://doi.org/10.47582/jompac.1506991

Abstract

Amaç: Son yıllarda akut koroner sendrom (AKS)’nin prognostik değerlendirmesinde hematolojik parametrelerin kullanımı yaygındır. Bu yüzden çalışmamızda, bu hastalarda hemoglobin to red cell distribution width (RDW) ratio (HRR)’nin prognozla olan ilişkisi araştırıldı.
Materyal-metod: 01.09.2023- 01.04.2024 tarihleri arasında acil servise başvuran ve AKS tanısı alan hastalar retrospektif olarak değerlendirildi. HRR, hemoglobinin RDW’ye bölünmesiyle hesaplandı. Tüm hastalar HRR cut-off değerine göre yüksek ve düşük HRR’li hastalar olarak iki gruba ayrıldı. Tüm parametreler bu iki hasta grubu arasında istatistiksel olarak karşılaştırıldı. Mortalite ile ilişkili olabilecek değişkenler receiver operating characteristic (ROC) analizine tabi tutuldu.
Bulgular: Yüksek HRR (>0.828) grubuna kıyasla düşük HRR (≤0.828) grubunda vazopressör, MV destek ihtiyacı ve hastane içi mortalite oranı anlamlı olarak daha yüksek tespit edildi (p<0.05 for all). ROC analizine göre, mortalite tahmini için HRR cut-off değeri 0.828 iken, sensitivite 78.8% ve spesifisite 92.5% idi (AUC: 0.885, p<0.001).
Sonuç: Başvuruda ölçülen HRR, AKS’li hastalarda prognostik değeri yüksek bir belirteçtir.

References

  • Xiu WJ, Zheng YY, Wu TT, et al. Hemoglobin-to-red-cell distribution width ratio is a novel predictor of long-term patient outcomes after percutaneous coronary intervention: a retrospective cohort study. Front Cardiovasc Med. 2022;16(9): 726025.
  • Kılıç O, Mustu M, Suygun H, Con E, Karakurt A, Fatma S. Hemoglobin/red cell distribution width ratio is associated with poor prognosis in patients with acute coronary syndrome in long-term follow-up. Int J Cardiovasc Sci. 2024;37(1):20230099.
  • Aktas G, Tel BA, Duman TT. Inflammatory indices derived from hemogram as prognostic markers of cardiovascular outcome. Int J Cardiovasc Sci. 2024;37(1):20240012.
  • Huo LK, Chen KY, Tse G, Liu T. Association of inflammatory markers based on routine blood with prognosis in patients underwent percutaneous coronary intervention. Medicine. 2024; 103(19):38118.
  • Li D, Ruan Z, Wu B. Association of red blood cell distribution width-albumin ratio for acute myocardial infarction patients with mortality: a retrospective cohort study. Clin Appl Thromb Hemost. 2022;28(1):10760296221121286.
  • Jian L, Zhang Z, Zhou Q, Duan X, Ge L. Red cell distribution width/albumin ratio: a predictor of in-hospital all-cause mortality in patients with acute myocardial infarction in the ICU. Int J Gen Med. 2023;27(16):745-756.
  • Huang S, Zhou Q, Guo N, et al. Association between red blood cell distribution width and in-hospital mortality in acute myocardial infarction. Medicine. 2021;100(15):25404.
  • Leonardi S, Gragnano F, Carrara G, et al. Prognostic implications of declining hemoglobin content in patients hospitalized with acute coronary syndromes. J Am Coll Cardiol. 2021;77(4):375-388.
  • Qin Z, Liao N, Lu X, Duan X, Zhou Q, Ge L. Relationship between the hemoglobin-to-red cell distribution width ratio and all-cause mortality in ischemic stroke patients with atrial fibrillation: an analysis from the MIMIC-IV database. Neuropsychiatry Dis Treat. 2022;18(18):341-354.
  • Wang J, Chen Z, Yang H, Li H, Chen R, Yu J. Relationship between the hemoglobin-to-red cell distribution width ratio and all-cause mortality in septic patients with atrial fibrillation: based on propensity score matching method. J Cardiovasc Dev Dis. 2022;9(11):400.
  • Qu J, Zhou T, Xue M, et al. Correlation analysis of hemoglobin-to-red blood cell distribution width ratio and frailty in elderly patients with coronary heart disease. Front Cardiovasc Med. 2021; 27(8):728800.
  • Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720-3826.
  • Ababneh MJ, Smadi MM, Al-Kasasbeh A, et al. Validity of TIMI risk score and heart score for risk assessment of patients with unstable angina/ non-st elevation myocardial infarction presented to an emergency department in Jordan. Open Access Emerg Med. 2023;18(15):465-471.
  • Salimi A, Zolghadrasli A, Jahangiri S, et al. The potential of HEART score to detect the severity of coronary artery disease according to SYNTAX score. Sci Rep. 2023;13(1):7228.
  • Rostami A, Tajlil A, Separham A, et al. Association between neutrophil-to-lymphocyte ratio and the systemic inflammatory immunologic index and the angiographic SYNTAX score and the TIMI flow grade in acute STEMI: a cohort study. J Tehran Heart Cent. 2021;16(4):147-155.
  • Li N, Zhou H, Tang Q. Red blood cell distribution width: a novel predictive indicator for cardiovascular and cerebrovascular diseases. Dis Markers. 2017;17(20):7089493.
  • Khaki S, Mortazavi SH, Bozorgi A, Sadeghian S, Khoshnevis M, Mahmoodian M. Relationship between red blood cell distribution width and mortality of patients with acute myocardial infarction referring to TEHRAN heart center. Crit Pathw Cardiol. 2015;14 (33):112-115.
  • Wei J, Yang RX, Ye Q, et al. Higher risk of myocardial injury in chest pain patients with elevated red blood cell distribution width. Clin Chim Acta. 2018;481(1):121-125.
  • Ishigami J, Grams ME, Naik RP, et al. Hemoglobin, albuminuria, and kidney function in cardiovascular risk: the ARIC (atherosclerosis risk in communities) study. J Am Heart Assoc. 2018;7(2):007209.
  • Uyarel H, Ergelen M, Cicek G, et al. Red cell distribution width as a novel prognostic marker in patients undergoing primary angioplasty for acute myocardial infarction. Coron Artery Dis. 2011;22(3):138-144.
  • Ndrepepa G, Neumann FJ, Menichelli M, et al. Prognostic value of hemoglobin drop in patients with acute coronary syndromes. Eur J Clin Invest. 2021;51(12):13670.
  • Bozkaya Y, Kurt B, Gürler F. A prognostic parameter in advanced non-small cell lung cancer: The ratio of hemoglobin-to-red cell distribution width. Int J Clin Oncol. 2019;24(7):798-806.
  • Yılmaz A, Mirili C, Tekin SB, Bilici M. The ratio of hemoglobin to red cell distribution width predicts survival in patients with gastric cancer treated by neoadjuvant FLOT: a retrospective study. Ir J Med Sci. 2020;189(1):91-102.
  • Song J, Yu T, Yan Q, Zhang Q, Wang L. Association of hemoglobin to red blood cell distribution width-standard deviation (RDW-SD) ratio and 3-month readmission in elderly chinese patients with heart failure:a retrospective cohort study. Int J Gen Med. 2023;24(16):303-315.
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Details

Primary Language English
Subjects Cardiology
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Azmi Eyiol 0000-0003-2740-1966

Birsen Ertekin 0000-0002-0630-8634

Publication Date August 29, 2024
Submission Date June 29, 2024
Acceptance Date July 22, 2024
Published in Issue Year 2024 Volume: 5 Issue: 4

Cite

AMA Eyiol A, Ertekin B. The relationship between hemoglobin to red cell distribution width (RDW) ratio (HRR) and prognosis in patients with acute coronary syndrome. J Med Palliat Care / JOMPAC / jompac. August 2024;5(4):188-192. doi:10.47582/jompac.1506991

TR DİZİN ULAKBİM and International Indexes (1d)

Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS]



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