Baseline red cell distribution width-to-albumin ratio and 12-month outcomes in sodium-glucose cotransporter…

Cohort studyJournal of cardiology· Aug 2026

Baseline red cell distribution width-to-albumin ratio and 12-month outcomes in sodium-glucose cotransporter 2 inhibitor-treated heart failure.

Ivana Jurin, Marin Viđak, Ivan Čović … Jasmina Ćatić

CardiologyCohort studyPrognosisQ1IF 3.4

Higher red cell distribution width-to-albumin ratio linked to worse 12-month heart failure outcomes

Baseline red cell distribution width-to-albumin ratio and 12-month outcomes in sodium-glucose cotransporter 2 inhibitor-treated heart failure.

Ivana Jurin … Jasmina Ćatić

Journal of cardiology · Aug 2026

Background

Red cell distribution width-to-albumin ratio (RAR) is associated with heart failure (heart failure) prognosis, but its incremental value and performance in contemporary sodium-glucose cotransporter 2 inhibitor (SGLT2i)-treated cohorts remain uncertain.

Methods

We re-audited a prospective registry and analyzed 641 unique patients with heart failure and baseline RAR measured before or on the day of SGLT2i initiation.

n = 641 unique patients

Results

higher RAR predicts worse 12-month outcomes, even after adjustment

HR 1.42 (95% CI 1.24 to 1.61)

null 1

1.24

1.61

CI excludes the null - significant

More results

There were 199 first events in the full time-to-event cohort.

The HR for death or heart failure hospitalization was 1.57 (95% CI 1.33-1.86).

Adding RAR increased Harrell's C-index modestly from 0.694 to 0.710 (likelihood-ratio p < 0.001).

More results

No statistically significant interaction was observed by SGLT2i type or initiation setting.

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Conclusion

Baseline RAR provides modest, confirmatory prognostic information in SGLT2i-treated heart failure but is not established as a treatment-response biomarker or stand-alone decision rule.

Baseline red cell distribution width-to-albumin ratio and 12-month outcomes in sodium-glucose cotransporter 2 inhibitor-treated heart failure.

Baseline red cell distribution width-to-albumin ratio and 12-month outcomes in sodium-glucose cotransporter 2 inhibitor-treated heart failure.

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