Red Blood Cell Distribution Width as an Effective Tool for Detecting Fatal Heart Failure in Super-elderly Patients

Nishizaki, Yuji; Yamagami, Shinichiro; Suzuki, Hikaru; Joki, Yusuke; Takahashi, Shuuhei; Sesoko, Masahiro; Yamashita, Haruyo; Kuremoto, Kenichi; Shinozaki, Tomohiro; Daida, Hiroyuki

doi:10.2169/internalmedicine.51.7938

Cited by 37 publications

(34 citation statements)

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“…Otro estudio relevante, es el reportado por Sán-chez-Chaparro y cols., quienes llevaron a cabo un estudio transversal que involucró a 217.567 sujetos españoles y trabajadores, que se realizaban exámenes de rutina; observándose que el RDW se asociaba a la presencia de síndrome metabólico, un factor de riesgo altamente predictor de diversas ECV como el IAM 24 . En los últimos dos años, también se ha sugerido que el aumento del RDW se asocia a la aparición de fibrilación auricular (FA) en pacientes con ECV y además, este aumento se ha correlacionado en la progresión y aparición de complicaciones en pacientes que ya padecieron FA 25,26 . Ertas y cols., demostraron en 132 pacientes que recibieron angioplastia coronaria electiva, los niveles de RDW fueron mayores en pacientes con FA respecto a los que no presentaron FA y adicionalmente, establecieron que un valor de RDW por sobre 13,45% previo a la angioplastía, correlacionó positivamente con la incidencia de FA con una sensibilidad y especificidad sobre el 60% 25 .…”

Section: Rdw Como Predictor De Morbilidad Cardiovascularunclassified

“…Ertas y cols., demostraron en 132 pacientes que recibieron angioplastia coronaria electiva, los niveles de RDW fueron mayores en pacientes con FA respecto a los que no presentaron FA y adicionalmente, establecieron que un valor de RDW por sobre 13,45% previo a la angioplastía, correlacionó positivamente con la incidencia de FA con una sensibilidad y especificidad sobre el 60% 25 . Asimismo, Nishizaki y cols, demostraron en forma más indirecta los hallazgos anteriores, mostrando que la presencia de FA en pacientes con IC se relacionó con un nivel de RDW mayor a 16,5% (OR de 2,36, 95% IC 1,10-5,04, p = 0,03) 26 .…”

Section: Rdw Como Predictor De Morbilidad Cardiovascularunclassified

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Ancho de distribución eritrocitaria como potencial biomarcador clínico en enfermedades cardiovasculares

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Section: Rdw Como Predictor De Morbilidad Cardiovascularunclassified

Ancho de distribución eritrocitaria como potencial biomarcador clínico en enfermedades cardiovasculares

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“…Recently it has been demonstrated that RDW could be considered an independent prognostic marker of cardiovascular events in patients with heart failure and peripheral artery diseases [1,2]. Some Authors studied the role or RDW as a predictor of mortality in patients with heart failure [3,4]; others analyzed the relation between NT-proBNP and RDW in these patients [5]; however the role of RDW in patients with acute coronary syndromes (ACS) is less known; there are in literature some data regarding the role of RDW in short-term outcomes in these patients [6]; some authors analyzed sixmonths outcomes, finding an independent association between higher RDW values and adverse outcomes [7].…”

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Red Blood Cell Distribution Width in Acute Coronary Syndromes

Biase¹,

Jacoangeli²,

Viola³

et al. 2013

TOEMJ

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Abstract:Objective: RDW is a measure of the variation of red blood cell width, reported as part of standard complete blood count; many paper reported results about the role of RDW in heart failure; the role of RDW in Acute Coronary Syndromes (ACS) is less known. Methods:We enrolled 173 consecutive patients, admitted to the coronary care unit of our hospital, with a diagnosis of obstructive ACS, documented by the evidence of obstructive coronary lesions on coronary angiography. We divided patients into two Groups: Group 1, with normal values of RDW; Group 2, with RDW values higher than normal range. Ventricular systolic function, was measured with echocardiography. Results: Patients of group 1 had a greater Ejection Fraction (p=0.03) and lower values of NT-proBNP (p=0.001). Finally we found a lower eGFR in patients of group 2, than in patients of group 1 (p=0.0001). Conclusions:Our results suggest that RDW is a routine and inexpensive test that can provide information concerning severity of clinical condition in acute phase of an ACS, both as regards the cardiac contractility, both with regard to renal function. These variables are important prognostic factors in patients after ACS.

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“…The Authors Reply We appreciate Shinohara's highly suggestive letter regarding our study (1). He recommends evaluating the mean corpuscular volume (MCV) upon examination of the red blood cell distribution width (RDW) in order to obtain a precise understanding of the cause of anemia.…”

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Red Blood Cell Distribution Width for Heart Failure

Nishizaki

Daida

2013

Intern. Med.

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The Authors Reply We appreciate Shinohara's highly suggestive letter regarding our study (1). He recommends evaluating the mean corpuscular volume (MCV) upon examination of the red blood cell distribution width (RDW) in order to obtain a precise understanding of the cause of anemia. He presumes that our study population exhibited clinical features of the super-elderly and that RDW values can be influenced by the hematological state of anemia of chronic disease (ACD) or anemia of inflammation (AI) induced by nutritional deficiencies.In our study, we used serum albumin values as an index of nutritional status. These values did not show any significant differences between the heart failure and non-heart failure groups. In addition, in the statistical analyses, we selected the hemoglobin concentration as a variable in the multivariate logistic model in order to minimalize the influence of anemia. Therefore, we paid considerable attention to the influence of nutritional deficits and anemia; however, assessing MCV would have surely improved the thoroughness of our study.As for MCV, Myojo et al. recently reported that macrocytosis, defined as an MCV >100 fL, is a predictor of cardiovascular events in postpercutaneous coronary intervention patients (2). They further reported that, in their study, the values of MCV in the statin therapy group were significantly lower than those in the non-statin therapy group. It is assumed that MCV is related to red blood cell morphology and the stability of erythrocyte membranes. Because erythrocyte membranes deliver oxygen and carbon dioxide, they function as antioxidants and can potentially be exposed to oxidative stress. Based on these background factors, the authors considered that oxidative stress plays a certain role in the relationship between macrocytosis and cardiovascular events. Because it has been reported that statins exhibit not only lipid-lowering effects, but also protective effects against oxidative stress, the authors pointed out that the antioxidant effects of statins could be a reason for the low MCV values observed in the statin therapy group.As mentioned above, the relationship between heart failure and MCV is very important and has attracted attention from various angles. We hope that the mechanisms underlying the relationship between red blood cell morphology and cardiovascular events will be clarified by further studies. The authors state that they have no Conflict of Interest (COI).

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Red Blood Cell Distribution Width as an Effective Tool for Detecting Fatal Heart Failure in Super-elderly Patients

Cited by 37 publications

References 19 publications

Ancho de distribución eritrocitaria como potencial biomarcador clínico en enfermedades cardiovasculares

Ancho de distribución eritrocitaria como potencial biomarcador clínico en enfermedades cardiovasculares

Red Blood Cell Distribution Width in Acute Coronary Syndromes

Red Blood Cell Distribution Width for Heart Failure

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