Red cell distribution width improves the prediction of prognosis after transcatheter aortic valve implantation

Collas, ValÃ©rie M.; Paelinck, Bernard P.; Rodrigus, Inez; Vrints, Christiaan J.; Craenenbroeck, Emeline M. Van; Bosmans, Johan

doi:10.1093/ejcts/ezv152

Cited by 18 publications

(15 citation statements)

References 20 publications

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“…[152122] It is considered as a sensitive and low-cost prognostication marker, which may combine with other hematological parameters (such as mean platelet volume or neutrophil-to-lymphocyte ratio) to provide better outcome predictive value. [23] However, the use of RDW among noncardiac surgical condition is less common.…”

Section: Discussionmentioning

confidence: 99%

Preoperative red cell distribution width: Not a useful prognostic indicator for 30-day mortality in patients who undergo major- or ultra-major noncardiac surgery

Cheung

Shum

Chan

et al. 2016

Indian Journal of Critical Care Medicine

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Background:Red cell distribution width (RDW) has been shown to be associated with mortality in cardiac surgical patients. This study investigates the association of RDW with the 30-day mortality for those patients who undergo major- or ultra-major noncardiac surgery.Methods:Patients who received major- or ultra-major noncardiac surgery between July 2012 and May 2013 were included in the study and patients those with preoperative hemoglobin <10 g/day were excluded from the study. Patients were followed till day 30 from the date of surgery or death, whichever occurred earlier.Results:The overall 30-day mortality for major- and ultra-major surgery was 11.4%. The mean RDW of the 30-day survivors was 13.6 ± 1.6 and that of nonsurvivors was 14.2 ± 2.1 (P < 0.001). Other factors that were significantly different (P < 0.05) between survivors and nonsurvivors included age, sex, preoperative pulse rate, current or ex-alcoholic, the American Society of Anesthesiologists score, diabetes mellitus, use of antihypertensives, sepsis with 48 h before surgery, preoperative hemoglobin, white cell count, sodium, urea, creatinine, albumin, international normalized ratio (INR), pH, base excess, estimated blood loss, and emergency surgery. Logistic regression revealed that preoperative RDW > 13.35% (P = 0.025, odds ratio [OR]: 1.52), INR (P = 0.008, OR: 4.49), albumin level (P < 0.001, OR: 1.10), use of antihypertensives (P = 0.001, OR: 1.82), and preoperative pulse rate (P = 0.006, OR: 1.02) independently predicted the 30-day mortality. However, the area under receiver operating characteristic curve for the prediction of 30-day mortality using RDW was only 0.614.Conclusions:Although preoperative RDW independently predicted 30-day mortality in patients who underwent major- or ultra-major noncardiac surgery, it may not serve as an influential prognostic indicator in view of its low sensitivity and specificity.

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Section: Discussionmentioning

confidence: 99%

Preoperative red cell distribution width: Not a useful prognostic indicator for 30-day mortality in patients who undergo major- or ultra-major noncardiac surgery

Cheung

Shum

Chan

et al. 2016

Indian Journal of Critical Care Medicine

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“…15–18 For example, RDW elevation is associated with increased mortality after percutaneous coronary intervention and transcatheter aortic valve implantation. 19, 20 Not surprisingly, obesity, a disease state associated with increased mortality, is associated with increased RDW; as such, controlling for initial BMI was necessary in this study.…”

Section: Discussionmentioning

confidence: 99%

Red cell distribution width is a novel biomarker that predicts excess body-mass index loss 1 year after laparoscopic Roux-en-Y gastric bypass

et al. 2016

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Introduction Bariatric surgery is the most effective method for producing sustained weight loss, improving obesity-associated comorbidities and reducing inflammation in the morbidly obese population. The red cell distribution width (RDW) is a novel marker of inflammation that is usually reported as part of a complete blood count. In this study, we tested our hypothesis that red cell distribution width might represent a novel biomarker predictive of excess body-mass index loss (EBMIL) following laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods Five hundred and forty-seven included LRYGB patients from a single institution were individually reviewed, noting both pre-operative RDW and percent excess BMI loss at six months and one year post-LRYGB (%EBMIL180 and %EBMIL365, respectively). Bivariate and multivariate linear regression analysis was conducted between age, gender, initial body-mass index (BMI0) and RDW and each of the two endpoints, to assess the independence of RDW as a predictor of post-operative success. Results The median RDW was 13.9 (13.3 – 14.6)%, and median EBMIL180 and EBMIL365 were 55.4 (45.2 – 66.7)% and 71.3 (58.9 – 87.8)%, respectively. After controlling for age, gender and BMI0, RDW was associated with %EBMIL365 (B = −1.4 [−2.8 – −0.002]%, P = .05), but not %EBMIL180 (B = −0.6 [−1.6 – 0.5]%, P = .30. Upon Kruskal-Wallis analysis, patients with a pre-operative RDW > 15.0% had significantly lower %EBMIL than those in the <13.0% (P < .001) and 13.0–15.0% (P < .01) strata. Conclusions RDW is predictive of EBMIL at one year following LRYGB. This represents a novel pre-operative biomarker that may provide clinically useful prognostic information.

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“…However, since there is no general definition of frailty available, further research is necessary in order to compose optimal criteria to evaluate frailty in aortic valve stenosis. Also, red cell distribution width gained interest in the risk estimation of TAVI patients [9,[22][23].…”

Section: Discussionmentioning

confidence: 99%

“…According to the guidelines, patient selection for TAVI relies on the multidisciplinary heart team, evaluating technical aspects of the procedure, as well as the procedural risk of the patient. As already reported before, surgical risk scores [logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE), EuroSCORE II and Society of Thoracic Surgeons (STS) score] could be helpful, but are limited for these purposes [4][5][6][7][8][9]. Recently, new risk scores have been developed, specifically for patients suffering from severe, symptomatic aortic valve stenosis undergoing TAVI.…”

Section: Introductionmentioning

confidence: 99%

Validation of transcatheter aortic valve implantation risk scores in relation to early and mid-term survival: a single-centre study

Collas

Heyning

Paelinck

et al. 2015

Interact CardioVasc Thorac Surg

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The aim of this study was to validate recently proposed risk scores for the prediction of mortality up to 1 year after transcatheter aortic valve implantation (TAVI), using a self-expandable valve (CoreValve). METHODS:In this single-centre study, 225 consecutive patients with severe symptomatic aortic valve stenosis, who underwent TAVI between December 2007 and January 2015, were included. Conventional surgical risk scores (logistic EuroSCORE, EuroSCORE II and STS score) were calculated as well as newly proposed TAVI risk scores (TAVI 2 -SCORe, STT Score and OBSERVANT score). Medium-term survival of the patients was assessed up to 1 year after TAVI. RESULTS:The median age was 82 (77-86) years and 45.3% were male. Patients were categorized into 'non-high risk' or 'high risk' according to logistic EuroSCORE >20%, EuroSCORE II >8%, STS score >10%, TAVI 2 -SCORe >2, STT score >12% and OBSERVANT score >6. Thirty-day and 1-year survival rates were significantly different between 'non-high-risk' and 'high-risk' patients according to the STS score (1 year: low: 84.4% vs high: 67.0%, P = 0.010) and according to OBSERVANT score (1 year: low: 85.2% vs high: 68.4%, P = 0.005). In contrast, TAVI 2 -SCORe and STT score did not discriminate 'non-high-risk' and 'high-risk' patients. This was confirmed by Cox regression analysis [STS score >10%: hazard ratio: 2.484 (1.206-5.115), P = 0.014; OBSERVANT score >6: hazard ratio: 2.532 (1.295-4.952), P = 0.007]. CONCLUSIONS:In this single-centre study, OBSERVANT and STS score most accurately predicted early and mid-term survival in patients undergoing TAVI, using a self-expandable valve (CoreValve).

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Red cell distribution width improves the prediction of prognosis after transcatheter aortic valve implantation

Abstract: Elevated RDW is a significant predictor for adverse events and increased 1-year mortality after TAVI. Adding RDW to the classical STS score could be a valuable strategy to improve preoperative risk assessment in potential TAVI candidates.

Cited by 18 publications

References 20 publications

Preoperative red cell distribution width: Not a useful prognostic indicator for 30-day mortality in patients who undergo major- or ultra-major noncardiac surgery

Preoperative red cell distribution width: Not a useful prognostic indicator for 30-day mortality in patients who undergo major- or ultra-major noncardiac surgery

Red cell distribution width is a novel biomarker that predicts excess body-mass index loss 1 year after laparoscopic Roux-en-Y gastric bypass

Validation of transcatheter aortic valve implantation risk scores in relation to early and mid-term survival: a single-centre study

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