Red cell distribution width in heart failure: Prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state

Förhécz, Zsolt; Gombos, Tímea; Borgulya, Gábor; Pozsonyi, Zoltán; Prohászka, Zoltán; Jánoskúti, Lívia

doi:10.1016/j.ahj.2009.07.024

Cited by 561 publications

(547 citation statements)

References 26 publications

Supporting

Mentioning

470

Contrasting

Unclassified

Order By: Relevance

“…general population, individuals with chronic heart failure) have recently reported a relationship between RDW and estimated GFR levels <1 ml s −1 m −2 [23,24]. Therefore, consistent with these studies [23,24], we suggest that RDW also plays a role as a marker of nephropathy in patients with diabetes, possibly mediated through macrovascular damage. The lack of association between RDW and retinopathy was unexpected.…”

Section: Discussionsupporting

confidence: 76%

“…Thus it is possible that microvascular disease and the related inflammatory process of retinopathy may occur mostly at the local tissue level and not be related to systemic inflammation [18,26]. Since RDW seems to reflect systemic inflammatory processes known to affect the macrovasculature [6,24], this may explain, at least partially, its relationship with macrovascular but not microvascular disease processes. Previous prospective studies have described a role of RDW as a predictive marker for CVD morbidity and mortality in several populations [4][5][6][7].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Association between red blood cell distribution width and macrovascular and microvascular complications in diabetes

et al. 2011

View full text Add to dashboard Cite

Aims/hypothesis Red blood cell distribution width (RDW) has been reported to be a risk marker of morbidity and mortality for cardiovascular disease in various study populations. However, no studies have investigated the relationship between RDW and diabetes complications. We therefore evaluated RDW as a marker of macrovascular and microvascular complications in a nationally representative sample of the adult diabetes population in the USA. Methods A cross-sectional study was performed using the nationwide 1988 to 1994 data set from the Third National Health and Nutrition Examination Survey. The association between RDW quartiles and macrovascular and microvascular complications was evaluated in 2,497 non-pregnant adults aged 20 years and older and affected by diabetes. Logistic regression modelling was used to adjust for potential confounding.

show abstract

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Association between red blood cell distribution width and macrovascular and microvascular complications in diabetes

et al. 2011

View full text Add to dashboard Cite

show abstract

“…8,10,[28][29][30][31] It has been proposed that during HF, RDW levels have some features in common with a combination of chronic inflammation and oxidative stress. 32 Both RDW and CTEPH have some common features from the point of inflammation. For these reasons, RDW may reflect multiple factors related to the association with the pulmonary hypertension.…”

Section: Discussionmentioning

confidence: 99%

Red cell distribution width

et al. 2014

View full text Add to dashboard Cite

The most important long-term complication of pulmonary thromboembolism is chronic thromboembolic pulmonary hypertension (CTEPH) that is associated with considerable morbidity and mortality. It is uncertain why some patients with acute pulmonary embolism (PE) develop CTEPH and others do not. Elevated red cell distribution width (RDW) has been associated with adverse outcomes of heart failure, PE, and idiopathic pulmonary hypertension. The aim of the present study was to investigate whether RDW might be a predictor of CTEPH in PE patients or not. This study is a retrospective cohort study. A total of 203 consecutive patients with acute PE were included. The RDW was higher in the CTEPH patients than the patients without CTEPH (17.04 + 3.46, 14.64 + 1.82, respectively, p ¼ 0.015). RDW was also higher in the CTEPH patients at the time of diagnosis of CTEPH during follow-up compared with the baseline RDW level at the time of PE diagnosis (18.63 + 3.58, 17.02 + 3.59, respectively, p ¼ 0.014). The optimal cutoff value of the RDW for predicting CTEPH was 14.65. The area under the curve of RDW for the prediction of CTEPH was 0.735 (95% confidence interval (CI): 0.600-0.869); in cases with RDW levels >14.65%, the specificity, sensitivity, and negative predictive value for CTEPH were 62% (95% CI: 0.55-0.69), 75% (95% CI: 0.47-0.92), and 96.7% (95% CI: 0.91-0.99), respectively. A multivariate regression analysis showed that RDW, hazard ratio: 1.58 (95% CI: 1.09-2.30), was a predictor of CTEPH (p ¼ 0.016). High level of RDW was an independent predictor of CTEPH in PE patients. Therefore, RDW levels may provide a prediction for CTEPH in PE patients.

show abstract

“…[16][17][18] In the present study, patients with a 90-day adverse event had lower BMI, albumin, total cholesterol, triglycerides, and low-density lipoprotein cholesterol, fi ndings that are consistent with those of a previous study. 6) RDW might have clinical relevance as an easy and inexpensive surrogate marker for nutritional status associated with a poor prognosis. 6) Persistent infl ammation is known to be a principal pathophysiologic fi nding and poor prognostic factor for heart failure.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Prognostic Value of Red Cell Distribution Width and NT-proBNP for Short-Term Clinical Outcomes in Acute Heart Failure Patients

Jia

Chen

et al. 2014

Int. Heart J.

View full text Add to dashboard Cite

SummaryComparison of the prognostic value of red cell distribution width (RDW) and N-terminal pro B-type natriuretic peptide (NT-proBNP) for short-term clinical outcomes in acute heart failure (AHF) patients has not been fully investigated.A total of 128 patients with AHF were enrolled and followed for 3 months. Primary endpoints were cardiovascular (CV) events, defi ned as cardiac death and/or readmission for HF. Baseline RDW and NT-proBNP were measured at admission.The 30-day and 90-day CV event rates were 16.4% and 35.9%, respectively. NT-proBNP was higher in people with cardiovascular events at both time points, while RDW was signifi cantly higher only at the 90-day time point. The area under the ROC curve of RDW (area under the ROC curve = 0.695) for the prediction of CV events was higher than that of NT-proBNP (area under the ROC curve = 0.610) at the 90-day time point, but lower at the 30-day time point. Cox hazard analysis revealed RDW and NT-proBNP were independent predictive factors of a 90-day CV event (RDW, hazard ratio, 4.610, 95% confi dence interval 1.935-10.981, P = 0.001; NT-proBNP, hazard ratio, 3.661, 95% confi dence interval 1.125-11.907, P = 0.031). Kaplan-Meier survival analysis revealed that patients with an RDW level > 14.5% and NT-proBNP > 1471.5 pg/mL were at highest risk for a CV event (P < 0.001).RDW and NT-proBNP are strong independent predictors of 90-day cardiovascular events in patients hospitalized with AHF. RDW can add prognostic value to NT-proBNP for predicting early cardiovascular events. (Int Heart J 2014; 55: 58-64) Key words: Marker, Prognosis A cute heart failure (AHF) has been defi ned as new-onset or gradual or rapidly worsening heart failure signs and symptoms requiring urgent therapy. 1) It is the leading cause of hospitalization in adults over 65 years.2) AHF may result from new onset of ventricular dysfunction or, more typically, exacerbation of chronic heart failure symptoms. 3)Recognizing such higher risk patients, however, may be challenging. Although numerous parameters indicate the prognosis of heart failure, most are costly to evaluate and are assessed only in research.4) Red cell distribution width (RDW) is a measure of the variability in size of circulating erythrocytes. 5)This parameter is a widely investigated and routine laboratory value reported as a component of complete blood count.A previous study has shown RDW can be a significant independent predictor of all-cause mortality and hospital readmission for patients with chronic heart failure (CHF).6) It was also found to be an independent and addictive predictor of early mortality in patients with acute dyspnea. 7) Higher levels of RDW correlate to poorer survival in stroke, 8) myocardial infarction 9) and pulmonary hypertension. 10) However, little is known about the prognostic value of RDW in the short-term outcome in acute heart failure. Accordingly, in order to determine the prognostic utility of RDW in short-term adverse outcome in patients with AHF, we conducted a prospective study to compare RDW ...

show abstract

Red cell distribution width in heart failure: Prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state

Cited by 561 publications

References 26 publications

Association between red blood cell distribution width and macrovascular and microvascular complications in diabetes

Association between red blood cell distribution width and macrovascular and microvascular complications in diabetes

Red cell distribution width

Comparison of Prognostic Value of Red Cell Distribution Width and NT-proBNP for Short-Term Clinical Outcomes in Acute Heart Failure Patients

Contact Info

Product

Resources

About