Journal of Personalized Medicine
Association of the Red Cell Distribution Width–Albumin Ratio with Myocardial Strain, Mortality, and Heart Failure Hospitalization: A Retrospective Cohort Study
By Sherif Ahmed, Kamal Awad, Abdelrahman H. Hafez and 12 others.
Abstract
Aims
The aims of this study were to evaluate the association between the red cell distribution width (RDW)–albumin ratio (RAR) and subclinical myocardial impairment, as assessed by left ventricular global longitudinal strain (LVGLS), and to examine the relationships between the RAR, heart failure (HF) hospitalization, and all-cause mortality.
Methods
We conducted a retrospective cohort study on adults who underwent transthoracic echocardiography (TTE) with LVGLS assessment across three Mayo Clinic centers (2017–2024) and who had RDW and serum albumin measured on the same day or within seven days. The RAR was calculated as RDW/albumin and categorized into the following tertiles: <2.93, 2.93–3.48, and >3.48. Impaired LVGLS was defined as >−18%. Associations between the RAR and outcomes were assessed using multivariable logistic regression (LVGLS) and Cox models (HF and mortality), adjusting for demographics and comorbidities.