Background: Red blood cell distribution width (RDW) has been showed to have independent predictive ability of mortality in patients with coronary artery disease and HF. However, no relevant research is established to demonstrate the relationship between RDW and heart failure hospitalization (HFH) in patients who received pacemaker.
Methods: The baseline RDW was individually recorded at admission in patients with pacemaker implantation. Patients were assigned to high and low RDW groups based on cut-off values. Restricted cubic splines were used to model the RDW-HFH association. The curve of patients free of HFH was plotted via the Kaplan-Meier method. And the significance of association between RDW and HFH was analyzed using both crude and adjusted cox proportional hazard model with hazard ratios (HR) and 95% confidence intervals (CI).
Results: A total of 927 patients who successfully received pacemaker implantation were enrolled. Seventy and seven (8.3%) patients met the endpoint, and 61(12.8%) patients had RDW≥13.45. Analysis of the receiver operating characteristicscurve for RDW demonstrated an optimal cut-off value of 13.45. The incidence of HFH in patients with high level of RDW were higher than that in those patients with low level of RDW (P<0.001). Moreover, despite controlling for other potential risk factors, the incidence of HFH was higher than the high RDW group (HR=2.197, 95% CI:1.638-5.196, P<0.001).
Conclusion: High RDW contributes to HFH in patients with pacemaker implantation during the long-term follow-up, suggesting that RDW can effectively predict the probability of HFH for patients with pacemaker implantation.