Prognostic value of the red blood cell distribution width-to-albumin ratio in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention
ZHOU Jun
LIN Song
ZHENG Ya-guo
Abstract：Objective To investigate the predictive value of the red blood cell distribution width-to-albumin ratio(RAR)for long-term prognosis in patients with ST-segment elevation myocardial infarction(STEMI)undergoing primary percutaneous coronary intervention(PCI).Methods We consecutively enrolled 1124 STEMI patients who underwent primary PCI at Nanjing First Hospital between July 2011 and April 2019.Baseline data were collected,including demographic characteristics,laboratory parameters,coronary angiography findings,and secondary preventive medications.The primary endpoint was all-cause mortality,while secondary endpoints included cardiac death,recurrent myocardial infarction,stent thrombosis,ischemic stroke,and target vessel revascularization.The safety endpoint was BARC type 3 or 5 major bleeding.Results During a median follow-up of 75±32 months,all-cause mortality occurred in 124 patients(11.0%).ROC curve analysis demonstrated that RAR predicted all-cause mortality with an area under the curve(AUC)of 0.701.At a cutoff value of 3.58,the sensitivity and specificity were 62.9%and 72.0%,respectively.The high-RAR group(RAR≥3.58)had significantly higher rates of all-cause mortality(HR=3.859,P<0.001),cardiac death,BARC type 3 or 5 major bleeding,and stent thrombosis rates than the low-RAR group.No sig-nificant differences were observed in recurrent myocardial infarction,target vessel revascularization,or ischemic stroke between groups.Multivariable Cox analysis identified age,Killip class Ⅲ-Ⅳ,hyperlipidemia,creatinine,uric acid,high RAR,left ventricular ejection fraction,single-vessel disease,intra-aortic balloon pump implantation,and ti-cagrelor use as independent predictors of all-cause mortality in STEMI patients.Conclusion RAR is a novel and readily available biomarker that effectively predicts all-cause mortality in STEMI patients,offering significant potential for risk stratification in clinical practice.
Keywords：Acute ST-segment elevation myocardial infarctionRed blood cell distribution width-to-albumin ratioPercutaneous coronary interventionPrognosis
Publication Date：2026-02-25
Online Publishing Date：2026-03-16(First online date of this platform, not the publication date of the document)
Pages：6( 127-132 )