Red Cell Distribution Width and Patient Outcome in Cardiovascular Disease: A ‘’Real-World’’ Analysis

Talarico, Marisa; Manicardi, Marcella; Vitolo, Marco; Malavasi, Vincenzo Livio; Valenti, Anna Chiara; Sgreccia, Daria; Rossi, Rosario; Boriani, Giuseppe

doi:10.3390/jcdd8100120

Cited by 15 publications

(12 citation statements)

References 26 publications

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“…The age distribution of the patients evaluated by our study is typical of a cardiological case series, with approximately half of the cases being over the age of 75, and the distribution of comorbidities is consistent with the features of patients undergoing periodic cardiological assessments [ 47 , 48 ]. A similar analysis was performed by our group at the same outpatient clinics two years ago during the first COVID-19 outbreak period [ 14 ].…”

Section: Discussionsupporting

confidence: 66%

DIGItal Health Literacy after COVID-19 Outbreak among Frail and Non-Frail Cardiology Patients: The DIGI-COVID Study

Vitolo

Ziveri

Gozzi

et al. 2022

JPM

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Background: Telemedicine requires either the use of digital tools or a minimum technological knowledge of the patients. Digital health literacy may influence the use of telemedicine in most patients, particularly those with frailty. We aimed to explore the association between frailty, the use of digital tools, and patients’ digital health literacy. Methods: We prospectively enrolled patients referred to arrhythmia outpatient clinics of our cardiology department from March to September 2022. Patients were divided according to frailty status as defined by the Edmonton Frail Scale (EFS) into robust, pre-frail, and frail. The degree of digital health literacy was assessed through the Digital Health Literacy Instrument (DHLI), which explores seven digital skill categories measured by 21 self-report questions. Results: A total of 300 patients were enrolled (36.3% females, median age 75 (66–84)) and stratified according to frailty status as robust (EFS ≤ 5; 70.7%), pre-frail (EFS 6–7; 15.7%), and frail (EFS ≥ 8; 13.7%). Frail and pre-frail patients used digital tools less frequently and accessed the Internet less frequently compared to robust patients. In the logistic regression analysis, frail patients were significantly associated with the non-use of the Internet (adjusted odds ratio 2.58, 95% CI 1.92–5.61) compared to robust and pre-frail patients. Digital health literacy decreased as the level of frailty increased in all the digital domains examined. Conclusions: Frail patients are characterized by lower use of digital tools compared to robust patients, even though these patients would benefit the most from telemedicine. Digital skills were strongly influenced by frailty.

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Section: Discussionsupporting

confidence: 66%

DIGItal Health Literacy after COVID-19 Outbreak among Frail and Non-Frail Cardiology Patients: The DIGI-COVID Study

Vitolo

Ziveri

Gozzi

et al. 2022

JPM

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“…Over the last decade, changes in RDW have been associated with outcomes in several discrete populations [ 4 , 5 ], such as in patients with cardiovascular disease [ 6 ] including stable coronary artery disease [ 7 ], acute coronary syndromes [ 8 ], acute myocardial infarction [ 9 ], stroke [ 10 ] and heart failure (HF). The changes of RDW in HF is the focus of the present work.…”

Section: Introductionmentioning

confidence: 99%

Red Blood Cell Distribution Width in Heart Failure: Pathophysiology, Prognostic Role, Controversies and Dilemmas

Xanthopoulos

Giamouzis

Dimos

et al. 2022

JCM

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Red blood cell distribution width (RDW), an integral parameter of the complete blood count (CBC), has been traditionally used for the classification of several types of anemia. However, over the last decade RDW has been associated with outcome in patients with several cardiovascular diseases including heart failure. The role of RDW in acute, chronic and advanced heart failure is the focus of the present work. Several pathophysiological mechanisms of RDW’s increase in heart failure have been proposed (i.e., inflammation, oxidative stress, adrenergic stimulation, undernutrition, ineffective erythropoiesis, reduced iron mobilization, etc.); however, the exact mechanism remains unknown. Although high RDW values at admission and discharge have been associated with adverse prognosis in hospitalized heart failure patients, the prognostic role of in-hospital RDW changes (ΔRDW) remains debatable. RDW has been incorporated in recent heart failure prognostic models. Utilizing RDW as a treatment target in heart failure may be a promising area of research.

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“…Thrombosis might arise due to the atherosclerotic status, induced by inflammatory cytokines, which is a common mechanism of MINS. 28 Moreover, an inverse relationship has been found between serum antioxidant concentrations and RDW. 29 Through surgery and anesthesia stimulation, the higher extent of oxidative stress also aggravates the instability and further increases the risk of MINS.…”

Section: Discussionmentioning

confidence: 99%

Higher Preoperative Red Blood Cell Distribution Width Increases the Risk of Myocardial Injury After Noncardiac Surgery in Advanced-Age Patients: A Retrospective Cohort Study

Liu¹,

Zhang²,

Zhang³

et al. 2023

CIA

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Background Myocardial injury after noncardiac surgery (MINS) has been associated with worse outcomes. The aim of our study was to investigate the relationship between higher red blood cell distribution width (RDW) and postoperative 30-day MINS among advanced-age patients. Methods This was a retrospective observational study including advanced-age patients (≥65 years old) who underwent noncardiac surgery between January 2017 and August 2019 at the First Medical Center of the Chinese People’s Liberation Army General Hospital. Patients were divided into two groups according to the cutoff value identified the lowest risk using Restricted Cubic Splines (RCS) model. The primary outcome was the incidence of MINS within 30 days after surgery. The relationship between RDW and MINS was investigated by univariable and multi-variable logistic regression analysis. Propensity score (PS) analysis, including propensity score matching (PSM) and inverse probability treatment weighting (IPTW), as well as subgroup analysis were also conducted to identify the effect of RDW. Results The result of the RCS analysis showed that the risk of MINS in advanced-age patients increases when the baseline RDW is >12.8%. In the univariate analysis, baseline RDW >12.8% was a risk factor for postoperative MINS [odds ratio (OR)=2.11; 95% confidence interval (CI): 1.83–2.44; p<0.001]. After adjustment for all possible components, there was also a high risk of MINS for patients with elevated RDW [Adjusted OR (aOR)=1.43; 95% CI: 1.27–1.61; p<0.001). The relationship remained after PS analysis (aOR=1.24; 95% CI: 1.04–1.47; p=0.016 in PSM; aOR=1.23; 95% CI: 1.05–1.44; p=0.012 in IPTW, respectively). Significant differences between two groups were established in the incidence rate of postoperative cardiac complications and mortality. Conclusion Elevated preoperative RDW is significantly associated with an increased risk of MINS within postoperative 30 days.

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Red Cell Distribution Width and Patient Outcome in Cardiovascular Disease: A ‘’Real-World’’ Analysis

Cited by 15 publications

References 26 publications

DIGItal Health Literacy after COVID-19 Outbreak among Frail and Non-Frail Cardiology Patients: The DIGI-COVID Study

DIGItal Health Literacy after COVID-19 Outbreak among Frail and Non-Frail Cardiology Patients: The DIGI-COVID Study

Red Blood Cell Distribution Width in Heart Failure: Pathophysiology, Prognostic Role, Controversies and Dilemmas

Higher Preoperative Red Blood Cell Distribution Width Increases the Risk of Myocardial Injury After Noncardiac Surgery in Advanced-Age Patients: A Retrospective Cohort Study

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