The objective of the study was to evaluate the Hb/RDW ratio and investigate its association with three-month clinical outcomes in patients with ADHF.
Material and methods. This longitudinal observational cohort study included patients aged ≥18 years hospitalized with ADHF. The primary outcome was a three-month composite of all-cause mortality and HF rehospitalization. Multivariate logistic regression and Cox proportional hazards regression models were used for analysis.
Results. A total of 223 patients with ADHF were included. The median Hb/RDW ratio was 0.86 (IQR: 0.73–0.97). Patients were categorized into two groups based on the median Hb/RDW ratio: high Hb/RDW (≥0.86, n=115) and low Hb/RDW (<0.86, n=108). Multivariate logistic regression analysis showed that a low Hb/RDW ratio was associated with female sex, chronic kidney disease (CKD), history of peripheral arterial disease (PAD), higher log-transformed NT-proBNP levels, and elevated left ventricular ejection fraction (LVEF) (all p<0.05). The primary outcome occurred in 49 patients (22%), including 7 deaths (3.2%). The area under the ROC curve for predicting clinical outcomes was 0.710 (95% confidence interval [CI]: 0.621–0.799, p<0.001), with a sensitivity of 76.4% and a specificity of 59.2%. The multivariate Cox proportional hazards model revealed a significant association between a low Hb/RDW ratio and adverse clinical outcomes (hazard ratio: 2.331, 95% CI: 1.118–4.861, p=0.024).
Conclusions. A low Hb/RDW ratio was associated with an increased risk of three-month clinical outcomes in patients with ADHF, particularly in those with comorbidities such as CKD, PAD, elevated NT-proBNP and LVEF.
Keywords: acute decompensated heart failure, hemoglobin-to-red blood cell distribution width ratio, prognosis, risk stratification.
Full text sources https://doi.org/10.31688/ABMU.2025.60.1.01
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Truong H. HOANG
Address: Department of Internal Medicine, Faculty of Medicine, Pham Ngoc Thach University of Medicine, 02 Duong Quang Trung Street, Ward 12, District 10, Ho Chi Minh City, Vietnam.
E-mail: truonghh@pnt.edu.vn; Phone + (84) 32-5665-419
