Red Cell Distribution Width Is Associated With Incident Myocardial Infarction in a General Population: The Tromsø Study

Abstract

BackgroundRed cell distribution width (RDW), a measure of the variability in size of circulating erythrocytes, is associated with mortality and adverse outcome in selected populations with cardiovascular disease. It is scarcely known whether RDW is associated with incident myocardial infarction (MI). We aimed to investigate whether RDW was associated with risk of first‐ever MI in a large cohort study with participants recruited from a general population.Methods and ResultsBaseline characteristics, including RDW, were collected for 25 612 participants in the Tromsø Study in 1994–1995. Incident MI during follow‐up was registered from inclusion through December 31, 2010. Cox regression models were used to calculate hazard ratios with 95% confidence intervals for MI, adjusted for age, sex, body mass index, smoking, hemoglobin, white blood cells, platelets, and other traditional cardiovascular risk factors. A total of 1779 participants experienced a first‐ever MI during a median follow‐up time of 15.8 years. There was a linear association between RDW and risk of MI, for which a 1% increment in RDW was associated with a 13% increased risk (hazard ratio 1.13; 95% CI, 1.07 to 1.19). Participants with RDW above the 95th percentile had 71% higher risk of MI compared with those with RDW in the lowest quintile (hazard ratio 1.71; 95% CI, 1.34 to 2.20). All effect estimates were essentially similar after exclusion of participants with anemia (n=1297) from the analyses.ConclusionRDW is associated with incident MI in a general population independent of anemia and cardiovascular risk factors.

Prognostic value of red blood cell distribution width in patients with left ventricular systolic dysfunction: Insights from the COMMIT-HF registry

“…Elevated RDW had been shown to predict poor outcomes in the normal population [15,16], in patients with CAD [2][3][4][5][6], and in patients with HF [8][9][10][11][12]. The present analysis is the first to demonstrate the predictive value of RDW both in patients with ischemic and nonischemic LVSD.…”

“…[19]. The results of prospective studies with long-term follow-up (Tromsø and National Health and Nutrition Examination Survey) demonstrate that high RDW values are associated with increased risk of myocardial infarction (MI) and mortality due to CAD in the general population [15,16], and in elderly patients without age-associated diseases [20]. Tonelli et al have shown that RDW is a risk factor for MI, stroke and symptomatic HF in patients with stable CAD [4].…”

The decisive role of red cell distribution width in carotid endarterectomy patients

“…[2][3][4][5][6][7][8] A prospective study conducted by the National Health and Nutrition Examination Surveys (NHANES) reported that RDW is an independent atherosclerotic risk factor, apart from the conventional risk factors and nutritional deficiencies in patients who did not have CVD. [2] Comprehensive prospective and randomized studies on CHD, MI, HF, and stroke showed that RDW was a strong predictor of the mortality in the middle or older ages.…”

“…[2] Comprehensive prospective and randomized studies on CHD, MI, HF, and stroke showed that RDW was a strong predictor of the mortality in the middle or older ages. [3][4][5][6] Studies associated with stroke and RDW usually demonstrate the results related with the severity of stroke, outcome and the course of disease, [14][15][16][17] the relationship between the RDW, CCA-IMT, and CP has been mostly investigated in carotid artery disease studies. [5,8] However, CCA and IMT are subclinical atherosclerotic markers; [9,10] and it seems it would be beneficial, if the relationship between the RDW and atherosclerotic CAS, which increases stroke, is investigated in patients undergoing CEA.…”

“…[1] There are numerous comprehensive studies denoting the importance of increased RDW values being the deterministic factor for death in healthy and high-risk individuals in terms of myocardial infarction (MI) and heart failure (HF), as well as in the development, severity, and outcome of stroke, and even for all-cause mortality. [2][3][4][5][6][7][8] In the developing cardiac pathologies, the relationship between the coronary heart diseases (CHD) and RDW values have been put forward, while the relation with the intima-media thickness of the common carotid arteries (CCA-IMT), carotid plaques (CPs), and RDW values have been established for carotid arterial diseases. [5,[8][9][10] Therefore, these variables are effective in predicting stroke independently from the carotid arterial stenosis (CAS).…”