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Background <p>Evidence links hemoglobin levels to atrial fibrillation prognosis, but hemoglobin is also known to change with age. The hemoglobin-to-age ratio (HAR) integrates age and hemoglobin. Its impact on the prognosis of non-valvular AF (NVAF) remains uncertain. Our aim is to investigate the relationship between HAR and clinical outcomes in NVAF patients.</p> Methods <p>In this retrospective cohort study, we conducted an analysis of clinical data from patients with NVAF who were hospitalized at the cardiology inpatient department (January 2023–July 2024). The exposure variable was the HAR, while the outcomes were unplanned cardiovascular readmission. Multivariate logistic regression evaluated HAR’s independent association with unplanned cardiovascular readmission risk, with predictive accuracy assessed via ROC curves and subgroup consistency through stratified analyses. Smooth curve fitting was utilized to investigate the linear relationship, and a series of sensitivity analyses were conducted to validate the robustness of the findings.</p> Results <p>This study included 985 participants (50.3% male, mean age 73.0 ± 11.9&#xa0;years). This study showed that each unit increase in HAR was associated with a 39% reduction at 30-day unplanned cardiovascular readmission risk (OR = 0.61, 95% CI 0.40–0.95, <i>P</i> = 0.027). Compared with the low HAR group, the high HAR group (HAR &gt; 1.94) showed a significantly lower 30-day unplanned cardiovascular readmission risk (OR = 0.49, 95% CI 0.28–0.87, <i>P</i> = 0.014). Similar results were observed for 90-day and 180-day unplanned cardiovascular readmission risks. There were no significant interactions found in the subgroup analysis. A linear association was identified between HAR and unplanned cardiovascular readmission risks. The optimal HAR cutoff value for predicting 30-day unplanned cardiovascular readmission risk was 1.40 (sensitivity 81.1%, specificity 42.1%, AUC = 0.618), 90-day unplanned cardiovascular readmission risk was 1.57 (sensitivity 67.8%, specificity 52.1%, AUC = 0.610), while for 180-day unplanned cardiovascular readmission risk, it was 1.56 (sensitivity 69.9%, specificity 48.9%, AUC = 0.603). Sensitivity analyses corroborated the robustness of our findings.</p> Conclusions <p>The HAR has a linear negative correlation with 30-day, 90-day, and 180-day unplanned cardiovascular readmission risks in patients with NVAF, a higher HAR was significantly associated with a lower risk of 30-day, 90-day, and 180-day unplanned cardiovascular readmission in patients with NVAF.</p>

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Association between HAR (hemoglobin-to-age ratio) and unplanned cardiovascular readmission risk in patients with non-valvular AF: a retrospective cohort study

  • 期刊论文

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  • 发表日期：

    2026年3月8日

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  • Jing Li,
  • LeiLei Guo,
  • ChunChang Qin

摘要

Background

Evidence links hemoglobin levels to atrial fibrillation prognosis, but hemoglobin is also known to change with age. The hemoglobin-to-age ratio (HAR) integrates age and hemoglobin. Its impact on the prognosis of non-valvular AF (NVAF) remains uncertain. Our aim is to investigate the relationship between HAR and clinical outcomes in NVAF patients.

Methods

In this retrospective cohort study, we conducted an analysis of clinical data from patients with NVAF who were hospitalized at the cardiology inpatient department (January 2023–July 2024). The exposure variable was the HAR, while the outcomes were unplanned cardiovascular readmission. Multivariate logistic regression evaluated HAR’s independent association with unplanned cardiovascular readmission risk, with predictive accuracy assessed via ROC curves and subgroup consistency through stratified analyses. Smooth curve fitting was utilized to investigate the linear relationship, and a series of sensitivity analyses were conducted to validate the robustness of the findings.

Results

This study included 985 participants (50.3% male, mean age 73.0 ± 11.9 years). This study showed that each unit increase in HAR was associated with a 39% reduction at 30-day unplanned cardiovascular readmission risk (OR = 0.61, 95% CI 0.40–0.95, P = 0.027). Compared with the low HAR group, the high HAR group (HAR > 1.94) showed a significantly lower 30-day unplanned cardiovascular readmission risk (OR = 0.49, 95% CI 0.28–0.87, P = 0.014). Similar results were observed for 90-day and 180-day unplanned cardiovascular readmission risks. There were no significant interactions found in the subgroup analysis. A linear association was identified between HAR and unplanned cardiovascular readmission risks. The optimal HAR cutoff value for predicting 30-day unplanned cardiovascular readmission risk was 1.40 (sensitivity 81.1%, specificity 42.1%, AUC = 0.618), 90-day unplanned cardiovascular readmission risk was 1.57 (sensitivity 67.8%, specificity 52.1%, AUC = 0.610), while for 180-day unplanned cardiovascular readmission risk, it was 1.56 (sensitivity 69.9%, specificity 48.9%, AUC = 0.603). Sensitivity analyses corroborated the robustness of our findings.

Conclusions

The HAR has a linear negative correlation with 30-day, 90-day, and 180-day unplanned cardiovascular readmission risks in patients with NVAF, a higher HAR was significantly associated with a lower risk of 30-day, 90-day, and 180-day unplanned cardiovascular readmission in patients with NVAF.