Association between the red blood cell distribution width-to-albumin ratio (RAR) and cardiovascular disease: A cross-sectional analysis of NHANES 2003 to 2016

The purpose of this study was to investigate the association between red blood cell distribution width and albumin ratio (RAR) and cardiovascular disease (CVD) and to determine the relevant thresholds. Researchers acquired data from the NHANES database between 2003 and 2016. Restricted cubic spline curve (RCS) analysis and multivariate logistic regression were conducted. The objective is to better understand how RAR influences CVD risk and potential nonlinear interactions. This study's sensitivity analysis included subgroup and interaction testing. The present study is predicated on the analysis of 10,909 individuals. Logit analysis has identified RAR as a separate CVD risk factor. When RAR was analyzed using quartiles, after accounting for potential confounders, RAR2, RAR3, and RAR4 were significantly linked to a higher risk of CVD, P < .001 for all. The RCS analysis revealed a nonlinear association between RAR and CVD. Subsequent to the execution of subgroup and interaction analyses, a consistency was demonstrated by all subpopulations in this study in relation to the overall population. To summarize, there is a nonlinear association between RAR and CVD among US adults. Adjusted modeling revealed that a RAR value below 0.416 was a critical threshold at which the odds ratio was very high at 9771.155 (95% confidence interval: 1491.836-63,998.653, P < .001), indicating a strong association with CVD. The tool under discussion has been demonstrated to facilitate clinicians in the assessment of the likelihood of cardiovascular events being predicted. RAR has been demonstrated to be a simple, effective and inexpensive method of predicting CVD.