Red blood cell distribution width/platelet ratio on admission as a predictor for in-hospital mortality in patients with acute myocardial infarction: a retrospective analysis from MIMIC-IV Database

BackgroundRed blood cell distribution width (RDW) to platelet ratio (RPR) is a novel inflammatory indicator. It integrates the risk prediction of RDW and platelet, which is associated with adverse outcomes. However, the predictive power of RPR in mortality for patients with acute myocardial infarction (AMI) remains uncertain. Thus, we aimed to explore the association between RPR and 180-day in-hospital mortality in patients with AMI.MethodsData on patients with AMI were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients were divided into two groups according to the optimal RPR cut-off value. The survival curve between high and low RPR groups was plotted via the Kaplan-Meier (KM) method. Univariate and multivariate Cox regression analyses were performed to determine the association between RPR on admission and 180-day in-hospital mortality.ResultsA total of 1266 patients were enrolled, of which 83 (6.8%) died within 180 days during the hospitalization. Compared with the survivor group, the non-survivor group had higher RPR on admission (0.11 +/- 0.07 vs. 0.08 +/- 0.06, P < 0.001). The KM curve indicated that the survival probability of low RPR group was higher than that of high RPR group. Multivariate Cox regression analysis demonstrated that higher RPR on admission was an independent and effective predictor of 180-day mortality in patients with AMI (hazard ratio [HR]: 2.677, 95% confidence interval [CI]: 1.159-6.188, P = 0.021).ConclusionHigher RPR was associated with higher in-hospital 180-day mortality in patients with AMI.

Automated summary

Red blood cell distribution width (RDW) to platelet ratio (RPR) is a novel inflammatory indicator that is associated with adverse outcomes. Our study found that RPR is associated with the 180-day in-hospital mortality in patients with acute myocardial infarction (AMI), highlighting its importance in predicting prognosis.