Determinants of Red Cell Distribution Width (RDW) in Cardiorenal Patients: RDW is Not Related to Erythropoietin Resistance

Emans, Mireille E.; Putten, Karien van der; Rooijen, Karlijn L. van; Kraaijenhagen, Rob J.; Swinkels, Dorine W.; Solinge, Wouter W. van; Cramer, Maarten J.; Doevendans, Pieter A.; Braam, Branko; Gaillard, Carlo A. J. M.

doi:10.1016/j.cardfail.2011.04.009

Cited by 67 publications

(54 citation statements)

References 33 publications

(50 reference statements)

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“…15,20,21) However, it has already been concluded that RDW predicts poor long-term outcome regardless of anemia status in AHF patients. 14,22,23) We observed that RDW was associated with low hemoglobin and depressed MCV, which are consistent with a state of impaired iron mobilization. RDW was an independent predictive factor after adjustment for hemoglobin in short-term outcome, though it had limitations in predicting 30-day clinical outcome.…”

Section: Discussionsupporting

confidence: 74%

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.

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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 ...

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Section: Discussionsupporting

confidence: 74%

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.

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“…Previous studies have demonstrated a relationship between RDW and indicators of inflammation such as erythrocyte sedimentation rate, high sensitivity C-reactive protein, fibrinogen, interleukin-6, soluble tumor necrosis factor (TNF) receptor I and soluble TNF receptor II [23,26,27]. Additionally, chronic inflammation leads to disturbances in iron metabolism and an impaired bone marrow response to erythropoietin, increasing the RDW value [27,28]. Chronic inflammation is often observed in patients with chronic kidney disease [25,29].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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“…Therefore, inflammation may contribute to increased RDW values by inhibiting responses to erythropoietin or the production of erythropoietin and shortening red blood cell survival [20]. Additionally, although Forthecz et al [21] associated this situation with erythropoietin resistance, Emans et al [22] related it to ineffective erythropoiesis formed by erythropoietic activity and increased erythrocyte destruction, claiming that it is not related to erythropoietin resistance. In this study, patients with schizophrenia had significantly higher RDW values compared with control subjects.…”

Section: Discussionmentioning

confidence: 99%

Relation between Red Blood Cell Distribution Width and Schizophrenia

Ayyıldız¹

2017

Int J Med Biochem

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Determinants of Red Cell Distribution Width (RDW) in Cardiorenal Patients: RDW is Not Related to Erythropoietin Resistance

Abstract: EPO resistance was not associated with RDW. RDW was associated with functional iron availability, erythropoietic activity, and interleukin-6 in anemic patients with CHF and CKD.

Cited by 67 publications

References 33 publications

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

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

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

Relation between Red Blood Cell Distribution Width and Schizophrenia

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