The relationship between red blood cell distribution width-albumin ratio (RAR) and prognosis in acute coronary syndrome

Aim: We investigated the association of red blood cell distribution width-albumin ratio (RAR) with prognosis and clinical risk scores in patients with acute coronary syndrome (ACS). Material and Methods: A total of 245 patients with ACS were retrospectively evaluated. RAR levels were obtained by dividing RDW by albumin. RAR was divided into two groups based on the cut-off value, with low and high RAR. All parameters were statistically compared between these groups. The correlation of RAR with risk scores was also evaluated. Results: Receiver operating characteristic (ROC) analysis revealed that albumin and RAR exhibited the highest values in mortality prediction (Area Under Curve [AUC]: 0.961, 0.951 respectively). The RAR exhibited a significant positive correlation with the troponin I, TIMI (thrombolysis in myocardial infarction), and HEART (history, EKG, age, risk factors, and troponin) risk scores (p < 0.05 for all). Discussion: RAR levels on admission may be a more powerful predictor of mortality than RDW, TIMI and HEART risk scores in patients with ACS. High RAR levels can readily identify those at high risk in these patients and can also predict adverse outcomes. In the prognostic risk classification of ACS patients, the RAR has high sensitivity and specificity with a cut-off value of 0.403.