Preoperative red cell width distribution to albumin ratio predicts early radial artery occlusion following coronary intervention via conventional transradial access

The red cell width distribution to albumin ratio (RAR) has recently been linked to various cardiovascular diseases. Radial artery occlusion (RAO) is a critical complication in patients undergoing coronary angiograph or percutaneous coronary intervention (CAG/PCI) via conventional transradial access (cTRA). However, the relationship between RAR and RAO remains unclear. This study investigates the association between RAR with the risk of early RAO. We retrospectively analyzed data from 389 participants in the CONDITION study. Participants underwent CAG/PCI via cTRA access and were divided into two groups based on the optimal cutoff value of RAR from receiver operating characteristic (ROC) analysis. Multivariate logistic regression and restricted cubic spline (RCS) analyses were performed to explore the association between RAR and RAO. A total of 26 participants (6.6%) developed early RAO as confirmed by ultrasonography. Patients with higher RAR levels had a significant higher prevalence of RAO. Multivariate logistic regression analysis revealed that elevated RAR levels were associated with an increased risk of RAO (OR: 3.673, 95% CI 1.566-8.615, P = 0.003). Moreover, a larger preoperative radial artery inner diameter was significantly protective against RAO (OR 0.299, 95% CI 0.109-0.846, P = 0.020). RCS analysis revealed a linear relationship between RAR and the risk of RAO. The current study showed a significant positive association between RAR and early RAO in individuals undergoing CAG/ PCI via cTRA. These findings highlight the importance of preoperative RAR assessment in identifying high-risk individuals for RAO.