Güçlü sinyallere sahip basit bir belirteç: akut koroner sendromda RDW/ albümin oranı ve öngördürücü rolü

Abstract

Amaç: Bu çalışma, akut koroner sendrom (AKS) tanısı alan hastalarda eritrosit da%ılım genişli%i/albümin oranının (RAR) prognostik de%erini araştırmayı amaçlamıştır. Gereç ve Yöntemler: Bu retrospektif, iki merkezli çalışmaya, 1 Ocak 2020 ile 1 Haziran 2025 tarihleri arasında Necmettin Erbakan Üniversitesi Tıp Fakültesi ve Konya Beyhekim E%itim ve Araştırma Hastanesi kardiyoloji kliniklerinde AKS tanısı ile izlenen 677 hasta dahil edildi. Çalışma popülasyonunun %63,5'i (n = 430) STEMI, %27,5'i (n = 186) NSTEMI ve %9,0'ı (n = 61) instabil angina pektoris (UAP) olarak sınıflandırıldı. Demografik, klinik ve laboratuvar parametreleri retrospektif olarak kaydedildi. RAR de%erleri şu formül kullanılarak hesaplandı: RDW (%) / Albümin (g/dL). Hastalar hastane içi mortaliteye göre iki gruba ayrıldı ve karşılaştırıldı. Bulgular: Genel ortalama RAR 4,03 ± 0,92 idi. Eksitus olan hastalarda RAR, hayatta kalanlara göre anlamlı derecede yüksekti (4,76 ± 1,01'e karşı 3,95 ± 0,84; p < 0,001). Lojistik regresyon analizinde yaş (OR 1,05; p = 0,001), ejeksiyon fraksiyonu (OR 0,93; p < 0,001) ve RAR (OR 2,87; p < 0,001) hastane içi mortalitenin ba%ımsız öngördürücüleri olarak belirlendi. ROC e%risi analizi, RAR için 0,864'lük bir AUC (%95 GA: 0,810–0,917) gösterdi; ≥ 0,373 kestirim de%erinde duyarlılık %93,2 ve özgüllük %71,2 olarak saptandı. Sonuçlar: RAR, AKS'li hastalarda mortaliteyi ve advers klinik sonuçları öngörmek için güçlü bir biyobelirteçtir. Rutin kan testlerinden kolayca elde edilen pratik ve düşük maliyetli bir parametre olarak RAR, klinisyenlere erken risk sınıflandırmasında yardımcı olabilir. Bu bulgular, kardiyovasküler prognozun belirlenmesinde inflamasyonun ve beslenme durumunun önemini desteklemektedir.

Keywords

• akut koroner sendrom
• RDW
• albümin
• RDW/albümin oranı
• prognoz
• mortalite

A simple marker with strong signals: the RDW/albumin ratio and its predictive role in acute coronary syndrome

Abstract

Aim: This study aimed to investigate the prognostic value of the red cell distribution width/albumin ratio (RAR) in patients diagnosed with acute coronary syndrome (ACS). Material and Methods: This retrospective, two-center study included 677 patients who were followed with a diagnosis of ACS between January 1, 2020, and June 1, 2025, at the cardiology departments of Necmettin Erbakan University Faculty of Medicine and Konya Beyhekim Training and Research Hospital. Of the study population, 63.5% (n = 430) had STEMI, 27.5% (n = 186) had NSTEMI, and 9.0% (n = 61) were classified as unstable angina pectoris (UAP). Demographic, clinical, and laboratory parameters were retrospectively recorded. RAR values were calculated using the formula: RDW (%) / Albumin (g/dL). Patients were divided into two groups according to in-hospital mortality and compared. Results: The overall mean RAR was 4.03 ± 0.92. RAR was significantly higher in patients who died compared with survivors (4.76 ± 1.01 vs. 3.95 ± 0.84; p < 0.001). In logistic regression analysis, age (OR 1.05; p = 0.001), ejection fraction (OR 0.93; p < 0.001), and RAR (OR 2.87; p < 0.001) were identified as independent predictors of in-hospital mortality. ROC curve analysis demonstrated an AUC of 0.864 (95% CI: 0.810–0.917) for RAR, with a sensitivity of 93.2% and a specificity of 71.2% at the cut-off value of ≥ 0.373. Conclusion: RAR is a strong biomarker for predicting mortality and adverse clinical outcomes in patients with ACS. As a practical, low-cost parameter easily derived from routine blood tests, RAR may assist clinicians in early risk stratification. These findings support the importance of inflammation and nutritional status in determining cardiovascular prognosis.

Keywords

• acute coronary syndrome
• RDW
• albumin
• RDW/albumin ratio
• prognosis
• mortality

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