HRR AS A PROGNOSTIC TOOL IN ACUTE CORONARY SYNDROME: CRITICAL APPRAISAL OF A RECENT STUDY COMMENTARY ON HRR UTILITY IN ACS

This commentary evaluates the study by Kudu and Danış investigating the prognostic value of the hemoglobin-to-red cell distribution width ratio (HRR) in patients presenting to the emergency department with acute coronary syndrome (ACS). As a readily available and cost-effective hematologic parameter, HRR has the potential to aid in early risk stratification. The study reports that HRR may predict 30-day cardiac mortality, all-cause mortality, and major adverse cardiovascular events. However, certain limitations—including its retrospective, single-center design, low specificity, lack of multivariate analysis, and absence of comparison with established risk scores—warrant caution in interpreting the findings. Furthermore, missing data on medication use and adherence could confound the results. While HRR shows promise as a screening tool, further prospective, multicenter studies are required to validate its clinical utility. This critical appraisal aims to highlight the study’s contributions and limitations, offering guidance for future research in emergency and cardiovascular medicine.