ASSESSING THE PROGNOSTIC VALUE OF THE HEMOGLOBIN-TO-RED CELL DISTRIBUTION WIDTH RATIO IN EMERGENCY DEPARTMENT PATIENTS WITH ACUTE CORONARY SYNDROME

Abstract

Objective: Acute coronary syndrome (ACS) is a critical condition requiring rapid evaluation in the emergency department. The hemoglobin-to-red cell distribution width ratio (HRR) has emerged as a potential prognostic biomarker, reflecting the combined effects of hemoglobin and red cell distribution width. This study aims to evaluate the prognostic value of HRR in patients presenting to the emergency department with ACS. Material and Methods: A retrospective cohort study was conducted at a single center, involving adult patients who were diagnosed with acute coronary syndrome upon presentation to the emergency department. HRR was calculated as the ratio of hemoglobin to red cell distribution width, and its association with 30-day cardiac mortality (CM), all-cause mortality (ACM), and major adverse cardiovascular events (MACE) was analyzed using Receiver Operating Characteristics (ROC) curve analysis. Results: The study included 688 patients, with a mean age of 61.9±12.3 years and 57% males. Lower HRR was significantly associated with higher 30-day CM, ACM, and MACE rates. ROC curve analysis showed HRR had acceptable discriminatory power with AUC values of 0.764 for 30-day CM, 0.718 for 30-day ACM, and 0.739 for 30-day MACE. An HRR cut-off value of 0.9 was determined, with sensitivities of 87.8%, 90.2%,and 88.7%, and specificities of 47.6%, 48.4%, and 48.9% for CM, ACM, and MACE, respectively. Conclusion: HRR is a useful prognostic marker for 30-day outcomes in ACS patients. Its easy accessibility and rapid availability makes it a practical tool for risk stratification in the emergency department.

Keywords

• Acute coronary syndrome
• hemoglobin
• major adverse cardiac events
• mortality

Acil Servisteki Akut Koroner Sendromlu Hastalarda Hemoglobin-Kırmızı Hücre Dağılım Genişliği Oranının Prognostik Değerinin Değerlendirilmesi

Abstract

Amaç: Akut koroner sendrom (AKS) acil serviste hızlı değerlendirme gerektiren kritik bir durumdur. Hemoglobin- kırmızı hücre dağılım genişliği oranı (HRR), hemoglobin ve kırmızı hücre dağılım genişliğinin birleşik etkilerini yansıtan potansiyel bir prognostik biyobelirteç olarak ortaya çıkmıştır. Bu çalışma, acil servise AKS ile başvuran hastalarda HRR'nin prognostik değerini değerlendirmeyi amaçlamaktadır. Gereç ve Yöntemler: Tek bir merkezde, acil serviste AKS tanısı konulan yetişkin hastaları kapsayan retrospektif bir kohort çalışması yürütülmüştür. HRR, hemoglobinin kırmızı hücre dağılım genişliğine oranı olarak hesaplanmış ve 30 günlük kardiyak ölüm (KÖ), tüm nedenlere bağlı ölüm (TNBÖ) ve majör istenmeyen kardiyovasküler olaylar (MİKO) ile ilişkisi Receiver Operating Characteristics (ROC) eğrisi analizi kullanılarak analiz edilmiştir. Bulgular: Çalışmaya 688 hasta dahil edilmiştir. Hastaların ortalama yaşı 61.9±12.3 yıl ve hastaların %57’si erkektir. Düşük HRR, daha yüksek 30 günlük KÖ, TNBÖ ve MİKO oranları ile anlamlı olarak ilişkilendirilmiştir. ROC eğrisi analizi, 30 günlük KM için 0,764, 30 günlük TNBM için 0.718 ve 30 günlük MİKO için 0.739 eğrinin altında kalan alan değerleri ile HRR'nin kabul edilebilir ayırt edici güce sahip olduğunu göstermiştir. HRR için eşik değer 0,9 olarak belirlenmiştir ve bu değer için KÖ, TNBÖ ve MİKO için sırasıyla %87.8, %90.2 ve %88.7 duyarlılık ve %47.6, %48.4 ve %48.9 özgüllüğe sahiptir. Sonuç: HRR, AKS hastalarında 30 günlük sonuçlar için faydalı bir prognostik belirteçtir. Kolay erişilebilir olması ve hızlı sonuç vermesi, acil serviste risk sınıflandırması için pratik bir araç olmasını sağlamaktadır.

Keywords

• Akut koroner sendrom
• hemoglobin
• major istenmeyen kardiyak olay
• mortalite

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