Red Cell Distribution Width and Mortality in Predominantly African-American Population With Decompensated Heart Failure

Zalawadiya, Sandip; Zmily, Hammam; Farah, Jareer; Daifallah, Suleiman; Ali, Omaima; Ghali, Jalal K.

doi:10.1016/j.cardfail.2010.11.006

Cited by 49 publications

(47 citation statements)

References 37 publications

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“…Prior research of patients with congestive heart failure, a condition with heightened neurohumoral activity [26], has shown that RDW levels are chronically elevated in these patients and are associated with adverse outcomes including CV morbidity and mortality [2,3,4]. Similarly, higher levels of neurohumoral activity have been independently associated with a higher incidence of MA [27.]…”

Section: Discussionmentioning

confidence: 99%

“…Red cell distribution width (RDW), a measure of anisocytosis, has traditionally been used for differential diagnosis of anemia [1], with more recent interest as a marker of higher all-cause and cardiovascular (CV) mortality and morbidity [2,3,4,5,6,7,8]. The most plausible explanations put forth for this purported association are chronic inflammation and oxidative stress, leading to elevation in RDW [9,10,11,12].…”

Section: Introductionmentioning

confidence: 99%

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Relationship between Red Cell Distribution Width and Microalbuminuria: A Population-Based Study of Multiethnic Representative US Adults

Afonso¹,

Zalawadiya

Veeranna³

et al. 2011

Nephron Clin Pract

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Introduction: Microalbuminuria (MA), a renal marker of vascular injury, is an independent predictor of cardiovascular (CV) events. Red cell distribution width (RDW), an emerging CV risk predictor, has not been evaluated for its association with MA. Methods: We evaluated 8,499 participants of the National Health and Nutrition Examination Survey (NHANES) 1999–2006, where RDW was evaluated as a continuous variable and in quartiles (Q₁ ≤12.1, Q₂ 12.2–12.5, Q₃ 12.6–13 and Q₄ >13). Multivariate adjusted logistic regression analysis was performed to estimate the odds of having MA (n = 1,736; adjusted for traditional CV risk factors, race, BMI, estimated glomerular filtration rate, hemoglobin, mean corpuscular volume, high-sensitivity C-reactive protein and nutritional factors deficiencies of iron, folate and vitamin B₁₂). Results: The prevalence of MA increased with increasing RDW (13.52% in Q₁ vs. 30.02% in Q₄, p < 0.001). The odds of having MA for those in Q₄ was 2.49 (95% CI: 1.95–3.18, p < 0.001) compared to those in Q₁ after the adjustments. No effect modification was observed by covariates on the association between RDW and MA. Conclusion: Elevated RDW is independently associated with a higher risk of MA. An interaction between chronic inflammation, oxidative stress, neurohumoral overactivity and endothelial dysfunction may explain this association and the attendant elevated CV/renal risk.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Relationship between Red Cell Distribution Width and Microalbuminuria: A Population-Based Study of Multiethnic Representative US Adults

Afonso¹,

Zalawadiya

Veeranna³

et al. 2011

Nephron Clin Pract

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“…7 RDW is also an independent predictor of overall mortality in healthy individuals, as well as a predictor of mortality in patients with various conditions such as cardiovascular diseases, obesity, malignancies, and chronic kidney disease. [8][9][10][11][12] RBC count and indices vary among individuals, and 40%-90% of this phenotypic variation is heritable. [13][14][15][16] Identifying the genes and biological pathways that contribute to this inter-individual variation in RBC traits could highlight modifiers of severity and/or therapeutic options for several hematological diseases.…”

Section: Introductionmentioning

confidence: 99%

Exome Genotyping Identifies Pleiotropic Variants Associated with Red Blood Cell Traits

Chami

Chen

Slater

et al. 2016

The American Journal of Human Genetics

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Red blood cell (RBC) traits are important heritable clinical biomarkers and modifiers of disease severity. To identify coding genetic variants associated with these traits, we conducted meta-analyses of seven RBC phenotypes in 130,273 multi-ethnic individuals from studies genotyped on an exome array. After conditional analyses and replication in 27,480 independent individuals, we identified 16 new RBC variants. We found low-frequency missense variants in MAP1A (rs55707100, minor allele frequency [MAF] = 3.3%, p = 2 × 10(-10) for hemoglobin [HGB]) and HNF4A (rs1800961, MAF = 2.4%, p < 3 × 10(-8) for hematocrit [HCT] and HGB). In African Americans, we identified a nonsense variant in CD36 associated with higher RBC distribution width (rs3211938, MAF = 8.7%, p = 7 × 10(-11)) and showed that it is associated with lower CD36 expression and strong allelic imbalance in ex vivo differentiated human erythroblasts. We also identified a rare missense variant in ALAS2 (rs201062903, MAF = 0.2%) associated with lower mean corpuscular volume and mean corpuscular hemoglobin (p < 8 × 10(-9)). Mendelian mutations in ALAS2 are a cause of sideroblastic anemia and erythropoietic protoporphyria. Gene-based testing highlighted three rare missense variants in PKLR, a gene mutated in Mendelian non-spherocytic hemolytic anemia, associated with HGB and HCT (SKAT p < 8 × 10(-7)). These rare, low-frequency, and common RBC variants showed pleiotropy, being also associated with platelet, white blood cell, and lipid traits. Our association results and functional annotation suggest the involvement of new genes in human erythropoiesis. We also confirm that rare and low-frequency variants play a role in the architecture of complex human traits, although their phenotypic effect is generally smaller than originally anticipated.

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“…Also in our study, although it is poor we found a positive correlation between RDW and hsCRP in patients with IDC. Zalawadiya et al (28) reported that in patients with HF taking statins RDW is lower. Anti-atherogenic property of statins has been shown via modulating inflammation and stabilizing atherosclerotic plaque.…”

Section: Discussionmentioning

confidence: 99%

Interrelation of RDW and coronary flow reserve in patient with idiopathic dilated cardiomyopathy

Özülkü¹,

Çalışkan²,

Güllü³

et al. 2014

Anadolu Kardiyol Derg

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Objective: Idiopathic dilated cardiomyopathy (IDC) impairs and reduces coronary flow reserve (CFR). High level of red cell distribution width (RDW) is an independent risk factor for cardiovascular diseases. Therefore, in this observational case-control study we have aimed to determine whether RDW level is associated with CFR impairment in patients with IDC. Methods: We examined 36 patients with IDC and 35 healthy subjects formed as a control group. In addition to this, patients with IDC were divided into two subgroups according to their CFR levels [normal CFR group (CFR value ≥2) and lower CFR group (CFR value<2)]. Control and patients groups were compared using the student t-test for multiple comparisons. The subgroups were compared using the Mann-Whitney U test for continuous variables and chi-square for categorical variables. The Pearson's and Spearman correlation analysis was used to test the possible associations between CFR and the study variables as appropriate. The receiver-operating characteristic (ROC) curve was determined to evaluate the predictive performance of RDW to detect low CFR. Results: There were no significantly differences between the lower and higher CFR groups' clinical data, baseline hemodynamic, medication and biochemical data except RDW and high-sensitivity C-reactive protein levels. We found that RDW level was a good predictor of low CFR at the receiver-operating characteristic curve. The area under the curve (AUC) was 73% (95% confidence interval between 0.56-0.90 is 95%, p: 0.018) After adjusting potential confounders include age, body-mass index, blood pressure, lipid and glucose, RDW independently associated with CFR level (Beta:-0.374; p=0.015) and hsCRP value (Beta:-0.520; p=0.001) were the independent predictors of lower CFR. Conclusion: Results showed that there was an independent correlation between RDW level and CFR level in patients with IDC.

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Red Cell Distribution Width and Mortality in Predominantly African-American Population With Decompensated Heart Failure

Cited by 49 publications

References 37 publications

Relationship between Red Cell Distribution Width and Microalbuminuria: A Population-Based Study of Multiethnic Representative US Adults

Relationship between Red Cell Distribution Width and Microalbuminuria: A Population-Based Study of Multiethnic Representative US Adults

Exome Genotyping Identifies Pleiotropic Variants Associated with Red Blood Cell Traits

Interrelation of RDW and coronary flow reserve in patient with idiopathic dilated cardiomyopathy

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