Red cell distribution width and prognosis in acute heart failure: ready for prime time!

Hullin, Roger; Barras, Nicolas; Abdurashidova, Tamila; Monney, Pierre; Regamey, Julien

doi:10.1007/s11739-018-1995-7

Cited by 12 publications

(15 citation statements)

References 10 publications

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“… 25 Also, inflammation may impair bone marrow function resulting in release of premature erythrocytes into circulation and increased RDW. 24 , 26 Impaired iron metabolism, which elevates RDW, is also common in HF and contributes to increased hospitalizations. 27 , 28 Vitamin D influences RDW by increasing iron availability and down‐regulating proinflammatory cytokines and hepcidin.…”

Section: Discussionmentioning

confidence: 99%

“…Inflammatory markers including tumor necrosis factor‐α and interleukin‐6 are increased and may negatively impact prognosis 25 . Also, inflammation may impair bone marrow function resulting in release of premature erythrocytes into circulation and increased RDW 24,26 . Impaired iron metabolism, which elevates RDW, is also common in HF and contributes to increased hospitalizations 27,28 .…”

Section: Discussionmentioning

confidence: 99%

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Prognostic value of RDW alone and in combination with NT‐proBNP in patients with heart failure

Liang

Huang

Zhao

et al. 2022

Clinical Cardiology

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Background Red blood cell distribution width (RDW) and N‐terminal pro brain natriuretic peptide (NT‐proBNP) may predict the prognosis of heart failure (HF). However, the impact of combined RDW and NT‐proBNP levels as a prognostic marker of HF remains unclear and the significance of this combination at various time‐points has not been sufficiently studied. Hypothesis RDW can predict prognosis in HF at various time‐points and combination with NT‐proBNP improves the prognostic value. Methods Patients admitted to HF care unit of Fuwai Hospital CAMS&PUMC (Beijing, China) with a diagnosis of HF from November 2008 to November 2018 were analyzed retrospectively. Results In total, 3231 patients with available RDW data at admission were evaluated (median age 58 years, 71.9% males, 39.7% coronary heart disease, 68.6% New York Heart Association [NYHA] III or IV). Median RDW and NT‐proBNP at admission were 13.4% (interquartile range [IQR]: 12.7%–14.5%), and 1723.00 pg/ml (IQR: 754.00–4006.25 pg/ml), respectively. During 2.9‐year median follow‐up, all‐cause death occurred in 1075 (33.27%) patients. Kaplan–Meier survival curve and Cox proportional‐hazard models, showed patients in the top quarter RDW had a 32.0% increased mortality compared to the bottom quarter (hazard ratio: 4.39, 95% confidence interval: 3.59–5.38; p <.001). The top quarter RDW retained independent prognostic value across HF with reduced ejection fraction [HFrEF], HF with mid‐range ejection fraction [HFmrEF], and HF with preserved ejection fraction [HFpEF] subgroups. Patients were subsequently divided into four groups by median RDW and NT‐proBNP. Comparison of Kaplan–Meier survival curves for various groups showed good risk stratification ( p < .001). Conclusions RDW is an independent predictor of mortality among patients with HF in the short‐, medium‐, and long‐term. Combination of RDW and NT‐proBNP improves the prognostic value. This is true across all clinical subtypes of heart failure (HFrEF, HFmrEF, HFpEF), and among most subgroups of patients with various comorbidities (infection, diabetes, hypertension).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prognostic value of RDW alone and in combination with NT‐proBNP in patients with heart failure

Liang

Huang

Zhao

et al. 2022

Clinical Cardiology

View full text Add to dashboard Cite

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“…It has been suggested that inflammation, neurohormonal and adrenergic system activation may bring about changes in RBC maturation by disturbing the red cell membrane, thereby leading to increased RDW [ 15 ]. HF is associated with the activation of both cell- and cytokine-mediated inflammatory pathways, which can impair bone marrow function with the release of premature erythrocytes into the circulation [ 16 ]. A correlation between RDW and established inflammatory markers such as interleukin-6 (IL-6) and C-reactive protein (CRP) has been reported [ 17 , 18 ].…”

Section: (Patho)physiology Of Rdw Increase In Heart Failurementioning

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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“…In addition, HF itself may also affect RDW. In patients with HF, chronic in ammatory stimulation leads to increased RDW (37). Furthermore, we also found that patients with higher RDW values had poorer health status, which may be the reason why RDW values can predict rehospitalization for heart failure in pacemaker patients.…”

Section: Discussionmentioning

confidence: 63%

High Red blood Cell Distribution Width Contributes to Heart Failure Hospitalization in Patients with Pacemaker Implantation: A Retrospective Cohort Study

Yao

Lian

Zheng

et al. 2022

Preprint

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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.

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Red cell distribution width and prognosis in acute heart failure: ready for prime time!

Cited by 12 publications

References 10 publications

Prognostic value of RDW alone and in combination with NT‐proBNP in patients with heart failure

Prognostic value of RDW alone and in combination with NT‐proBNP in patients with heart failure

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

High Red blood Cell Distribution Width Contributes to Heart Failure Hospitalization in Patients with Pacemaker Implantation: A Retrospective Cohort Study

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