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RDW/albümin oranı ile koroner arter ektazisi arasındaki ilişkinin değerlendirilmesi

Year 2025, Volume: 6 Issue: 3, 284 - 288, 18.06.2025
https://doi.org/10.47582/jompac.1705588

Abstract

Amaç:
Koroner arter ektazisi (KAE), inflamasyon ve olumsuz kardiyovasküler sonuçlarla ilişkili bir damar anomalisidir. Eritrosit dağılım genişliği/albumin oranı (RAR), sistemik inflamasyon ve beslenme durumunu yansıtan yeni bir biyobelirteç olarak ortaya çıkmıştır. Bu çalışmanın amacı, RAR ile KAE varlığı arasındaki ilişkiyi değerlendirmektir.
Yöntem:
Bu retrospektif çalışmaya, koroner anjiyografi ile KAE tanısı konmuş 80 hasta ile yaş ve cinsiyet açısından eşleştirilmiş 80 sağlıklı kontrol dahil edildi. RDW, serum albümin ve RAR dahil olmak üzere laboratuvar parametreleri analiz edildi. Gruplar arası karşılaştırmalar için Mann-Whitney U testi kullanıldı ve anlamlılık düzeyi p < 0.05 olarak belirlendi. Aktif enfeksiyonu, ileri organ yetmezliği veya malignitesi olan hastalar çalışma dışı bırakıldı.

Bulgular:
Demografik ve klinik değişkenler gruplar arasında benzerdi (p > 0.05). Serum albümin düzeyleri, kontrol grubuna kıyasla KAE grubunda anlamlı derecede düşüktü [41,0 (39,0–43,9) g/L vs. 43,9 (42,0–45,7) g/L; p < 0,001]. RDW tek başına gruplar arasında anlamlı fark göstermese de (p = 0,448), RAR KAE hastalarında [0,375 (0,338–0,410)] kontrol grubuna göre [0,355 (0,330–0,390)] anlamlı derecede yüksekti (p = 0,036). Ek bulgular olarak, hasta grubunda lenfosit ve trombosit sayılarında azalma; monosit sayısı ve ortalama trombosit hacminde (MPV) artış gözlendi. Bu durum pro-inflamatuar bir duruma işaret etmektedir.
Sonuç:
KAE hastalarında RDW/albumin oranı anlamlı şekilde artmış olup, bu oranın inflamasyonu yansıtan basit, ucuz ve etkili bir biyobelirteç olarak kullanılabileceğini düşündürmektedir. RDW ve albümin klinik uygulamada rutin olarak ölçülen parametreler olduğundan, bunların birlikte değerlendirilmesiyle elde edilen RAR, KAE’de risk sınıflandırmasını geliştirebilir. Bu bulguların doğrulanması ve RAR’ın KAE’deki prognostik değerinin netleştirilmesi için ileriye dönük, geniş ölçekli çalışmalara ihtiyaç vardır.

References

  • Lamtai M, Fihri Y, Faid S, et al. Coronary artery ectasia: case reports and literature review. Cureus. 2024;16(6):e62011. doi:10.7759/cureus.62011
  • Nough H, Moradi F, Varasteravan HR, et al. Assessment of prevalence and risk factors of isolated coronary artery ectasia: a 5-year double-center retrospective study in Yazd, Iran. Caspian J Intern Med. 2024; 15(2):244-250. doi:10.22088/cjim.15.2.244
  • Ahmad M, Mungee S. Coronary ectasia. In StatPearls [Internet]. StatPearls Publishing. 2022.
  • Ozcan OU, Gulec S. (2013). Coronary artery ectasia. Cor et Vasa. 2013; 55(3):e242-e247. doi:10.1016/j.crvasa.2013.01.003
  • Jiang L, Wei W, Kang S, Li XL, Luo Y. Insights into lipid metabolism and immune-inflammatory responses in the pathogenesis of coronary artery ectasia. Front Physiol. 2023;14:1096991. doi:10.3389/fphys.2023.1096991
  • Esposito L, Di Maio M, Silverio A, et al. Treatment and outcome of patients with coronary artery ectasia: current evidence and novel opportunities for an old dilemma. Front Cardiovasc Med. 2022;8:805727. doi:10.3389/fcvm.2021.805727
  • Alkhouli MA, Gil IJN, American College of Cardiology. Coronary ectasia: clinical implications and treatment options. ACC.org. 2019. https://www.acc.org/Latest-in-Cardiology/Articles/2019/06/07/08/24/Coronary-Ectasia
  • Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: a simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2015;52(2):86-105. doi:10.3109/10408363.2014.992064
  • Don Burl R, Kaysen G. Poor nutritional status and inflammation: serum albumin: relationship to inflammation and nutrition. Seminars in dialysis. Vol. 17. No. 6. Oxford, UK: Blackwell Science Inc, 2004. doi:10. 1111/j.0894-0959.2004.17603.x
  • Zhao N, Hu W, Wu Z, et al. The red blood cell distribution width-albumin ratio: a promising predictor of mortality in stroke patients. Int J Gen Med. 2021;14:3737-3747. doi:10.2147/IJGM.S322441
  • Li JJ, Nie SP, Qian XW, Zeng HS, Zhang CY. Chronic inflammatory status in patients with coronary artery ectasia. Cytokine. 2009;46(1):61-64. doi:10.1016/j.cyto.2008.12.012
  • Eckart A, Struja T, Kutz A, et al. Relationship of Nutritional status, ınflammation, and serum albumin levels during acute ıllness: a prospective study. Am J Med. 2020;133(6):713-722.e7. doi:10.1016/j.amjmed.2019.10.031
  • Vrachatis DA, Papathanasiou KA, Kazantzis D, et al. Inflammatory biomarkers in coronary artery ectasia: a systematic review and meta-analysis. Diagnostics (Basel). 2022;12(5):1026. doi:10.3390/diagnostics 12051026
  • Chen S, Guan S, Yan Z, et al. Prognostic value of red blood cell distribution width-to-albumin ratio in ICU patients with coronary heart disease and diabetes mellitus. Front Endocrinol (Lausanne). 2024; 15:1359345. doi:10.3389/fendo.2024.1359345
  • Jian L, Zhang Z, Zhou Q, Duan X, Ge L. Red cell distribution width/albumin ratio: a predictor of ın-hospital all-cause mortality in patients with acute myocardial ınfarction in the ICU. Int J Gen Med. 2023;16:745-756. doi:10.2147/IJGM.S393393
  • Li XL, Hong LF, Jia YJ, et al. Significance of red cell distribution width measurement for the patients with isolated coronary artery ectasia. J Transl Med. 2014;12:62. doi:10.1186/1479-5876-12-62
  • Cai Z, Wang Y, Li L, et al. Development and validation of a nomogram for predicting the risk of adverse cardiovascular events in patients with coronary artery ectasia. J Cardiovasc Dev Dis. 2021;8(12):186. doi:10. 3390/jcdd8120186
  • Liu Y, Sun S, Liu L. Association between the red blood cell distribution width-albumin ratio and cardiovascular diseases. Front Cardiovasc Med. 2025;12:1529533. doi:10.3389/fcvm.2025.1529533
  • Li N, Li J, Wang K. Association between red cell distribution width-albumin ratio and all-cause mortality in intensive care unit patients with heart failure. Front Cardiovasc Med. 2025;12:1410339. doi:10.3389/fcvm.2025.1410339
  • Arba IF, Multazam CCZ, Widiarti W, et al. Red blood cell distribution width to albumin ratio as novel prognostic biomarker in cardiovascular disease. Eur Heart J. 2024;45(Supplement_1):ehae666-3741. doi:10.1093/eurheartj/ehae666.3741

Evaluation of the relationship between the RDW/albumin ratio and coronary artery ectasia

Year 2025, Volume: 6 Issue: 3, 284 - 288, 18.06.2025
https://doi.org/10.47582/jompac.1705588

Abstract

Aims: Coronary artery ectasia (CAE) is a vascular abnormality associated with inflammation and adverse cardiovascular outcomes. The red blood cell distribution width-to-albumin ratio (RAR) has emerged as a novel biomarker reflecting systemic inflammation and nutritional status. This study aimed to evaluate the relationship between RAR and the presence of CAE.
Methods: In this retrospective study, 80 patients diagnosed with CAE via coronary angiography and 80 age-and sex-matched healthy controls were included. Laboratory parameters, including RDW, serum albumin, and RAR, were analyzed. The Mann-Whitney U test was used for group comparisons, and significance was set at p<0.05. Patients with active infection, severe organ failure, or malignancy were excluded.
Results: Demographic and clinical variables were similar between groups (p>0.05). Median (IQR) serum albumin levels were significantly lower in the CAE group compared to controls [41.0 (39.0–43.9) g/L vs. 43.9 (42.0–45.7) g/L; p<0.001]. Although RDW alone did not differ significantly between groups (p=0.448), the RAR was significantly higher in CAE patients [0.375 (0.338–0.410)] than in controls [0.355 (0.330–0.390)] (p=0.036). Additional findings included reduced lymphocyte and platelet counts and elevated monocyte counts and mean platelet volume (MPV) in the patient group, indicating a pro-inflammatory state.
Conclusion: The RDW/albumin ratio was significantly elevated in patients with CAE, suggesting that it may serve as a simple, inexpensive, and effective inflammatory biomarker in this population. While RDW and albumin are routinely available in clinical practice, their combined interpretation via RAR may provide additional insight into the inflammatory status of patients with CAE. Further prospective, large-scale studies are warranted to confirm these findings and clarify the prognostic value of RAR in CAE.

References

  • Lamtai M, Fihri Y, Faid S, et al. Coronary artery ectasia: case reports and literature review. Cureus. 2024;16(6):e62011. doi:10.7759/cureus.62011
  • Nough H, Moradi F, Varasteravan HR, et al. Assessment of prevalence and risk factors of isolated coronary artery ectasia: a 5-year double-center retrospective study in Yazd, Iran. Caspian J Intern Med. 2024; 15(2):244-250. doi:10.22088/cjim.15.2.244
  • Ahmad M, Mungee S. Coronary ectasia. In StatPearls [Internet]. StatPearls Publishing. 2022.
  • Ozcan OU, Gulec S. (2013). Coronary artery ectasia. Cor et Vasa. 2013; 55(3):e242-e247. doi:10.1016/j.crvasa.2013.01.003
  • Jiang L, Wei W, Kang S, Li XL, Luo Y. Insights into lipid metabolism and immune-inflammatory responses in the pathogenesis of coronary artery ectasia. Front Physiol. 2023;14:1096991. doi:10.3389/fphys.2023.1096991
  • Esposito L, Di Maio M, Silverio A, et al. Treatment and outcome of patients with coronary artery ectasia: current evidence and novel opportunities for an old dilemma. Front Cardiovasc Med. 2022;8:805727. doi:10.3389/fcvm.2021.805727
  • Alkhouli MA, Gil IJN, American College of Cardiology. Coronary ectasia: clinical implications and treatment options. ACC.org. 2019. https://www.acc.org/Latest-in-Cardiology/Articles/2019/06/07/08/24/Coronary-Ectasia
  • Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: a simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2015;52(2):86-105. doi:10.3109/10408363.2014.992064
  • Don Burl R, Kaysen G. Poor nutritional status and inflammation: serum albumin: relationship to inflammation and nutrition. Seminars in dialysis. Vol. 17. No. 6. Oxford, UK: Blackwell Science Inc, 2004. doi:10. 1111/j.0894-0959.2004.17603.x
  • Zhao N, Hu W, Wu Z, et al. The red blood cell distribution width-albumin ratio: a promising predictor of mortality in stroke patients. Int J Gen Med. 2021;14:3737-3747. doi:10.2147/IJGM.S322441
  • Li JJ, Nie SP, Qian XW, Zeng HS, Zhang CY. Chronic inflammatory status in patients with coronary artery ectasia. Cytokine. 2009;46(1):61-64. doi:10.1016/j.cyto.2008.12.012
  • Eckart A, Struja T, Kutz A, et al. Relationship of Nutritional status, ınflammation, and serum albumin levels during acute ıllness: a prospective study. Am J Med. 2020;133(6):713-722.e7. doi:10.1016/j.amjmed.2019.10.031
  • Vrachatis DA, Papathanasiou KA, Kazantzis D, et al. Inflammatory biomarkers in coronary artery ectasia: a systematic review and meta-analysis. Diagnostics (Basel). 2022;12(5):1026. doi:10.3390/diagnostics 12051026
  • Chen S, Guan S, Yan Z, et al. Prognostic value of red blood cell distribution width-to-albumin ratio in ICU patients with coronary heart disease and diabetes mellitus. Front Endocrinol (Lausanne). 2024; 15:1359345. doi:10.3389/fendo.2024.1359345
  • Jian L, Zhang Z, Zhou Q, Duan X, Ge L. Red cell distribution width/albumin ratio: a predictor of ın-hospital all-cause mortality in patients with acute myocardial ınfarction in the ICU. Int J Gen Med. 2023;16:745-756. doi:10.2147/IJGM.S393393
  • Li XL, Hong LF, Jia YJ, et al. Significance of red cell distribution width measurement for the patients with isolated coronary artery ectasia. J Transl Med. 2014;12:62. doi:10.1186/1479-5876-12-62
  • Cai Z, Wang Y, Li L, et al. Development and validation of a nomogram for predicting the risk of adverse cardiovascular events in patients with coronary artery ectasia. J Cardiovasc Dev Dis. 2021;8(12):186. doi:10. 3390/jcdd8120186
  • Liu Y, Sun S, Liu L. Association between the red blood cell distribution width-albumin ratio and cardiovascular diseases. Front Cardiovasc Med. 2025;12:1529533. doi:10.3389/fcvm.2025.1529533
  • Li N, Li J, Wang K. Association between red cell distribution width-albumin ratio and all-cause mortality in intensive care unit patients with heart failure. Front Cardiovasc Med. 2025;12:1410339. doi:10.3389/fcvm.2025.1410339
  • Arba IF, Multazam CCZ, Widiarti W, et al. Red blood cell distribution width to albumin ratio as novel prognostic biomarker in cardiovascular disease. Eur Heart J. 2024;45(Supplement_1):ehae666-3741. doi:10.1093/eurheartj/ehae666.3741
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Details

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

Tolga Memioğlu 0000-0002-3183-5815

Publication Date June 18, 2025
Submission Date May 24, 2025
Acceptance Date June 13, 2025
Published in Issue Year 2025 Volume: 6 Issue: 3

Cite

AMA Memioğlu T. Evaluation of the relationship between the RDW/albumin ratio and coronary artery ectasia. J Med Palliat Care / JOMPAC / jompac. June 2025;6(3):284-288. doi:10.47582/jompac.1705588

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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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