Red Blood Cell Distribution Width Adds Prognostic Value for Outpatients With Chronic Heart Failure

Bonaque, Juan C.; Pascual-Figal, Domingo A.; Manzano-Fernández, Sergio; González-Cánovas, Cristina; Vidal, Alfredo; Muñoz‐Esparza, Carmen; Garrido, Iris P.; Pastor‐Pérez, Francisco J.; Valdés, Mariano

doi:10.1016/j.rec.2011.12.007

Cited by 19 publications

(34 citation statements)

References 28 publications

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“…Moreover, the correlation between RDW and both LVEF and NYHA class was found strongly significant. This result confirms those of previous studies [7,[10][11][12][13][14][15]. Despite this, we hereby first suggested that RDW assessment in stable and closely followed-up chronic HF patients is more useful than mitral regurgitation grade, LV mass index, PWT, LVEDD, left atrial size, and E/A ratio.…”

Section: Discussionsupporting

confidence: 91%

“…However, recently, RDW has been found a good predictor marker for heart failure (HF) patients with reduced left ventricular ejection fraction (LVEF) (CHARM study) [7], with preserved LVEF [8], and for subject with prior myocardial infarction without HF (CARE study) [9]. Although these and other demonstrations [10][11][12][13][14], including a meta-analysis [15], no studies to our knowledge have yet investigated the predictive ability of RDW compared to traditionally evaluated echocardiographic parameters in chronic HF patients. We thus sought to examine this aspect in order to find how useful could routine RDW assessment be in this kind of subjects.…”

Section: Resultsmentioning

confidence: 99%

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Red cell distribution width and chronic heart failure: prognostic role beyond echocardiographic parameters

Vizzardi

Sciatti

Bonadei

et al. 2016

Monaldi Arch Chest Dis

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Aim. Red cell distribution width (RDW) is a measure of anisocytosis. Higher values are robustly associated to adverse outcome in several conditions, including chronic heart failure (HF). The present study aimed to compared its prognostic role with that of echocardiographic parameters in this kind of patients.Methods. 232 stable and optimally treated chronic HF patients were enrolled. We excluded subjects suffering from valvular diseases or atrial fibrillation. They underwent blood sampling and echocardiographic examination. The primary endpoint of the study was cardiovascular death and/or HF hospitalization in the first year after enrolment.Results. 49 patients reached the primary endpoint. RDW best cut-off at ROC curve was 14.45%. Univariate analysis associated mitral regurgitation grade, left ventricular ejection fraction (LVEF), posterior wall thickness (PWT), LV mass index, and RDW>14.45% to the primary endpoint. Multivariate regression analysis showed that LVEF, PWT, and RDW>14.45% predict the primary endpoint. Area under ROC curve was 0.808 for LVEF, 0.762 for NYHA class, and 0.761 for RDW.Conclusion. In chronic HF patients RDW is a better predictor of adverse outcome than several echocardiographic parameters associated to outcome itself (LV mass index, mitral regurgitation grade), predicts prognosis even adjusting for those parameters, age and NYHA class, and is associated to several echocardiographic measurements. In conclusion, RDW can expand our tool bag in order to better follow-up these patients. RiassuntoScopo. Il red cell distribution width (RDW) è una misura di anisocitosi. Valori elevati sono fortemente associati ad esiti sfavorevoli in plurime condizioni, tra cui lo scompenso cardiaco (SC) cronico. Lo scopo di questo studio era paragonare il suo ruolo prognostico con quello dei parametri ecocardiografici in questo tipo di pazienti.Metodi. Sono stati arruolati 232 pazienti affetti da SC cronico, stabili e con terapia ottimizzata. Sono stati esclusi i soggetti con valvulopatie o fibrillazione atriale. I pazienti sono stati sottoposti a prelievo di sangue ed ecocardiogramma. L'endpoint primario dello studio consisteva in morte cardiovascolare e/o ospedalizzazione per SC entro un anno dall'arruolamento.Risultati. 49 pazienti hanno raggiunto l'endpoint primario. Il miglior cut-off di RDW alla curva ROC è stato 14.45%. L'analisi uni variata ha associato il grado di insufficienza mitralica, la frazione di eiezione ventricolare sinistra (FEVS), lo spessore della parete posteriore del ventricolo sinistro (PP), la massa ventricolare sinistra indicizzata e RDW>14.45% all'endpoint primario. La regressione multivariata ha mostrato che FEVS, PP e RDW>14.45% predicono l'endpoint primario. L'area sotto la curva ROC è risultata 0.808 per la FEVS, 0.762 per la classe NYHA e 0.761 per l'RDW.Conclusione. In pazienti con SC cronico l'RDW è un miglior predittore di outcome sfavorevole rispetto a numerosi parametri ecocardiografici associati allo stesso outcome (massa ventricolare sinistra indicizzata, grado d...

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Section: Discussionsupporting

confidence: 91%

Section: Resultsmentioning

confidence: 99%

Red cell distribution width and chronic heart failure: prognostic role beyond echocardiographic parameters

Vizzardi

Sciatti

Bonadei

et al. 2016

Monaldi Arch Chest Dis

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show abstract

“…Of the 26 articles, 8 did not meet the inclusion criteria and 1 did not clear the value of HR that is whether primary endpoint events or secondary endpoint events in the patients of HF. The remaining 17 studies (18 data sets) [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] with a total of 41,311 patients were included in our meta-analysis.The main features of the studies on the association between RDW and HF outcomes are shown in Table 1. The studies were conducted in North America and Europe, with the exception of three [11,12,19] which were conducted in Asia.…”

mentioning

confidence: 99%

Prognostic value of red blood cell distribution width in heart failure patients: A meta-analysis

Shao¹,

Li²,

Li³

et al. 2015

International Journal of Cardiology

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“…Additionally, this study showed that anisocytosis is both a cause and a simple epiphenomenon due to underlying diseases. Increased RDW levels are seen not only in classical hematological diseases but also might be associated with cardiovascular disease and heart failure [13,14], stroke [15], diabetes associated complications [16], malignancy [17], peripheral artery disease, pulmonary arterial hypertension [18] and VTE. The mechanism underlying the relationship between RDW and VTE is still unclear.…”

Section: Discussionmentioning

confidence: 99%

“…So, for the next step, we compared provoked VTE and control subjects and found that RDW was higher in provoked VTE than control subjects (p \ 0.001). In several studies, it was shown that increased RDW levels were seen in heart failure, chronic renal insufficiency, systemic inflammation, COPD, malignancies and with diabetes mellitus complications [13][14][15][16][17][18]. The vast majority of these risk factors have been associated with provoked VTE.…”

Section: Discussionmentioning

confidence: 99%

Red Cell Distribution Width Has a Predictable Value for Differentiation of Provoked and Unprovoked Venous Thromboembolism

Ertop

Bilici

Engın

et al. 2015

Indian J Hematol Blood Transfus

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Venous thromboembolism (VTE) is generally classified as provoked or unprovoked. This dichotomy is important for following patients, mortality rate, prognosis and whether more efficient therapy is needed. In VTE patients, during initial diagnosis, it is not known exactly whether red cell distribution width (RDW) have a predictable value for this differentiation and pathogenesis. In this study, 298 patients with VTE and 197 control subjects were included. Patients with VTE were defined as provoked or unprovoked with respect to physical examination findings and laboratory values. Changes in RDW were tested between VTE patients and control subjects, provoked and unprovoked VTE patients, and separately with control subjects. RDW was found to be high in provoked and unprovoked groups compared with control group (p \ 0.001, p = 0.003 respectively). RDW was significantly high in provoked VTE patients group compared with unprovoked patients (p \ 0.001) and a cut-off value was found to be 13.6 %. In ROC analysis, sensitivity was 90.19 % and specificity was 82 % (95 % CI 85. . RDW could be used as a simple, costeffective and a reliable test independent of age in differentiation of provoked and unprovoked VTE. In order to better understand its role, prospective large homogenized population studies in different regions are necessary.

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Red Blood Cell Distribution Width Adds Prognostic Value for Outpatients With Chronic Heart Failure

Cited by 19 publications

References 28 publications

Red cell distribution width and chronic heart failure: prognostic role beyond echocardiographic parameters

Red cell distribution width and chronic heart failure: prognostic role beyond echocardiographic parameters

Prognostic value of red blood cell distribution width in heart failure patients: A meta-analysis

Red Cell Distribution Width Has a Predictable Value for Differentiation of Provoked and Unprovoked Venous Thromboembolism

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