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Background <p>Heart failure (HF) is a global health burden, affecting millions of people worldwide. This prospective study aimed to investigate the prognostic value of the red blood cell distribution width–albumin ratio (RAR) in HF patients.</p> Methods <p>This two-center cohort study included patients with symptomatic HF (NYHA functional class III–IV) from 2014 to 2016. Survival analysis, logistic regression, and Kaplan–Meier curves were employed to assess the association between RAR and prognosis.</p> Results <p>The study included 2151 HF patients. Significant differences in clinical profiles were observed across RAR groups. Patients with higher RAR were more likely to be female and had a greater prevalence of comorbidities such as atrial fibrillation, renal insufficiency, and hypoproteinemia. During the 6-year follow-up period, higher RAR was significantly associated with reduced survival probability (<i>P</i> &lt; 0.001). Elevated RAR was independently associated with a higher risk of HF re-hospitalization [HR(95% confidence interval; CI): 1.848 (1.502–2.275), <i>P</i> &lt; 0.001], cardiac death [HR (95% CI): 1.334 (1.074–1.657), <i>P</i> = 0.009], and all-cause death [HR(95%CI): 1.575 (1.283–1.933), <i>P</i> &lt; 0.001] at 3&#xa0;months. Furthermore, elevated RAR independently predicted a higher risk of HF re-hospitalization at 6&#xa0;years [HR(95%CI): 1.457(1.271–1.671), <i>P</i> &lt; 0.001] and all-cause mortality [HR(95%CI): 1.507 (1.318–1.723), <i>P</i> &lt; 0.001].</p> Conclusions <p>Elevated RAR levels are independently associated with a worse prognosis in HF patients, including higher risks of HF re-hospitalization and all-cause mortality. The RAR holds promise as a valuable tool for risk stratification and prognosis assessment in HF management.</p>

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Red blood cell distribution width–albumin ratio: a promising predictor of outcome in heart failure patients—a 6-year cohort study

  • 期刊论文

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  • 发表日期：

    2026年2月9日

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  • Conglin Wang,
  • Xiaojing Niu,
  • Yaping Bao,
  • Yang Yu,
  • Wenyi Wang,
  • Tianning Li,
  • Jianli Tian,
  • Xiaofei Wang

摘要

Background

Heart failure (HF) is a global health burden, affecting millions of people worldwide. This prospective study aimed to investigate the prognostic value of the red blood cell distribution width–albumin ratio (RAR) in HF patients.

Methods

This two-center cohort study included patients with symptomatic HF (NYHA functional class III–IV) from 2014 to 2016. Survival analysis, logistic regression, and Kaplan–Meier curves were employed to assess the association between RAR and prognosis.

Results

The study included 2151 HF patients. Significant differences in clinical profiles were observed across RAR groups. Patients with higher RAR were more likely to be female and had a greater prevalence of comorbidities such as atrial fibrillation, renal insufficiency, and hypoproteinemia. During the 6-year follow-up period, higher RAR was significantly associated with reduced survival probability (P < 0.001). Elevated RAR was independently associated with a higher risk of HF re-hospitalization [HR(95% confidence interval; CI): 1.848 (1.502–2.275), P < 0.001], cardiac death [HR (95% CI): 1.334 (1.074–1.657), P = 0.009], and all-cause death [HR(95%CI): 1.575 (1.283–1.933), P < 0.001] at 3 months. Furthermore, elevated RAR independently predicted a higher risk of HF re-hospitalization at 6 years [HR(95%CI): 1.457(1.271–1.671), P < 0.001] and all-cause mortality [HR(95%CI): 1.507 (1.318–1.723), P < 0.001].

Conclusions

Elevated RAR levels are independently associated with a worse prognosis in HF patients, including higher risks of HF re-hospitalization and all-cause mortality. The RAR holds promise as a valuable tool for risk stratification and prognosis assessment in HF management.