Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep 25:15:1359345.
doi: 10.3389/fendo.2024.1359345. eCollection 2024.

Prognostic value of red blood cell distribution width-to-albumin ratio in ICU patients with coronary heart disease and diabetes mellitus

Sheng Chen  1 , Senhong Guan  1 , Zhaohan Yan  1 , Fengshan Ouyang  2 , Shuhuan Li  3 , Lanyuan Liu  4 , Liuer Zuo  5 , Yuli Huang  1 , Jiankai Zhong  1
Affiliations

Prognostic value of red blood cell distribution width-to-albumin ratio in ICU patients with coronary heart disease and diabetes mellitus

Sheng Chen et al. Front Endocrinol (Lausanne). .

Abstract

Background: The red blood cell distribution width (RDW)-to-albumin ratio (RAR) has emerged as a potentially valuable prognostic indicator in diverse medical conditions. However, the prognostic significance of RAR in intensive care unit (ICU) patients with coronary heart disease (CHD) and diabetes mellitus (DM) remains uncertain and requires further investigation.

Methods: This study aims to investigate the prognostic significance of RAR in ICU patients with coexisting CHD and DM through a retrospective cohort analysis using data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database (version 2.2). The study population included patients aged 18 years or older who were diagnosed with both CHD and DM. The primary endpoint was 1-year mortality, and the secondary endpoints included 30-day mortality, 90-day mortality, hospital length of stay (LOS), and ICU LOS.

Results: A total of 3416 patients, of whom 64.64% were male, were included in the study. The 30-day mortality, 90-day mortality, and 1-year mortality were 7.08%, 7.44%, and 7.49%, respectively. After adjusting for confounding factors, multivariate Cox proportional risk analysis demonstrated that high RAR levels were associated with an increased risk of 30-day mortality (HR, 1.53 [95% CI 1.17-2.07], P = 0.006), 90-day mortality (HR, 1.58 [95% CI 1.17-2.13], P = 0.003), and 1-year mortality (HR, 1.58 [95% CI 1.17-2.13], P = 0.003). Furthermore, the restricted cubic spline (RCS) model indicated a linear relationship between RAR and 1-year mortality.

Conclusion: The results suggest that RAR holds potential as a valuable prognostic biomarker in ICU patients with both CHD and DM. Elevated RAR levels were found to be significantly associated with increased mortality during hospitalization, facilitating the identification of individuals at higher risk of adverse outcomes. These findings underscore the importance of incorporating RAR into risk stratification and overall management strategies for ICU patients with coexisting CHD and DM.

Keywords: MIMIC-IV; all-cause mortality; coronary heart disease; diabetes mellitus; red blood cell distribution width-to-albumin ratio.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study flow diagram in the present study. CHD, coronary heart disease; DM, diabetes mellitus; RAR, red blood cell distribution width-to-albumin ratio.
Figure 2
Figure 2
Restricted cubic spline model for 1-year mortality. (A) Unadjusted restricted cubic spline model for 1-year mortality. (B) Fully adjusted restricted cubic spline model for 1-year mortality. Adjusted risk factors including age, race, SBP, temperature, WBC, potassium, hypertension, hyperlipidemia, diabetes with complication, stroke, antiplatelet drugs, statins, SOFA score, and SIRS score. HR, hazard ratio; RAR, red blood cell distribution width-to-albumin ratio.
Figure 3
Figure 3
Kaplan–Meier survival analysis curves for 1-year mortality. RAR, red blood cell distribution width-to-albumin ratio.
Figure 4
Figure 4
Forest plot of the relationship between 1-year mortality and high RAR for subgroup analysis. COPD, chronic obstructive pulmonary disease; CKD, chronic kidney disease.
Figure 5
Figure 5
ROC curves of RAR and RDW to predict 1-year mortality. ROC, receiver operating characteristic; RAR, Red blood cell distribution width-to-albumin ratio; RDW, Red blood cell distribution width.
See this image and copyright information in PMC

References

    1. Liao Y, Zhang R, Shi S, Zhao Y, He Y, Liao L, et al. . Triglyceride-glucose index linked to all-cause mortality in critically ill patients: a cohort of 3026 patients. Cardiovasc Diabetol. (2022) 21:128. doi: 10.1186/s12933-022-01563-z - DOI - PMC - PubMed
    1. Wilson PW. Diabetes mellitus and coronary heart disease. Am J Kidney Dis. (1998) 32:S89–100. doi: 10.1053/ajkd.1998.v32.pm9820468 - DOI - PubMed
    1. Dwivedi AK, Dubey P, Reddy SY, Clegg DJ. Associations of glycemic index and glycemic load with cardiovascular disease: updated evidence from meta-analysis and cohort studies. Curr Cardiol Rep. (2022) 24:141–61. doi: 10.1007/s11886-022-01635-2 - DOI - PubMed
    1. Reaven GM. The role of insulin resistance and hyperinsulinemia in coronary heart disease. Metabolism. (1992) 41:16–9. doi: 10.1016/0026-0495(92)90088-r - DOI - PubMed
    1. DeStefano F, Ford ES, Newman J, Stevenson JM, Wetterhall SF, Anda RF, et al. . Risk factors for coronary heart disease mortality among persons with diabetes. Ann Epidemiol. (1993) 3:27–34. doi: 10.1016/1047-2797(93)90006-p - DOI - PubMed

LinkOut - more resources