Red cell distribution width in patients with atrial fibrillation

Balta, Şevket; Demır, Mustafa; Küçük, Uğur; Arslan, Zekeriya; Demırkol, Sait

doi:10.1111/joim.12182

Cited by 4 publications

(3 citation statements)

References 11 publications

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“…Additionally, elevated RDWs are associated with both the presence and the increased severity of spontaneous echo contrast in the left atrium [22], which is thought to be a manifestation of RBC aggregation and is linked to the development of thromboembolism. However, Balta et al [23] argued that RDW alone may not provide precise information to clinicians regarding the inflammatory statuses and prognoses of patients with AF. In contrast, our results suggested that elevated RDW levels among patients with AF remain an independent predictor of both all-cause mortality and MAEs based on a median follow-up period of 3.2 years.…”

Section: Discussionmentioning

confidence: 98%

The relationship between elevated red cell distribution width and long-term outcomes among patients with atrial fibrillation

Wan

Yang

Zhu

et al. 2015

Clinical Biochemistry

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Section: Discussionmentioning

confidence: 98%

The relationship between elevated red cell distribution width and long-term outcomes among patients with atrial fibrillation

Wan

Yang

Zhu

et al. 2015

Clinical Biochemistry

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“…RDW has recently been reported to also be an inflammatory indicator. There is mounting evidence linking elevated RDW and adverse outcomes in cardiac disease (2)(3)(4), pulmonary embolism (5), trauma (6), septic shock (7), acute pancreatitis (8), hepatitis (9), stroke (10), dementia (11), metabolic syndrome (12), and respiratory diseases such as non-small cell lung cancer (NSCLC) (13,14), chronic obstructive pulmonary disease (15), interstitial pneumonia (16) and sarcoidosis (17). High RDW has been associated with increased mortality and poor pulmonary function also in the general population (18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of red cell distribution width in elderly patients undergoing resection for non-small cell lung cancer

et al. 2016

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Background:The impact of red cell distribution width (RDW) on outcomes in elderly patients after surgery for non-small cell lung cancer (NSCLC) is not fully understood. Methods: We retrospectively analyzed 992 NSCLC patients who underwent curative resection between 1998 and 2012. The following variables were included in the analyses to evaluate the role of RDW: age, gender, smoking index, leukocyte count, neutrophil to lymphocyte ratio (NLR), hemoglobin, platelet count, albumin, C-reactive protein, carcinoembryonic antigen, respiratory function, histology, T factor, N factor, surgical approach, surgical procedures, complications and prognosis. Results: High RDW (>13.8) was an independent risk factor for morbidity [hazard ratio (HR) 2.1; P<0.01], recurrence (HR 2.0; P=0.01), overall survival (OS) (HR 2.1; P<0.01) and disease-free survival (DFS) (HR 2.0; P<0.01) in elderly patients (age ≥75 years, n=275), whereas it was not in younger patients (age <75 years, n=717). The surgical outcome was extremely poor in those older than 80 years with a RDW greater than 15% (morbidity, 56%; postoperative stay, 23 days; OS, 24%; DFS, 0%). RDW was unaffected by age (R =0.01; P=0.86) and elevated RDW without anemia was more prognostic than high RDW due to anemia in elderly patients. Conclusions: High RDW was significantly associated with high morbidity and reduced survival in elderly patients who underwent resection for NSCLC. Therefore, this parameter should be taken into account when surgery is considered in the elderly. investigation of the etiology of anemia (1). The volume of erythrocytes is consistent, and RDW is normal in the case of anemia caused by rapid bleeding, whereas the increase of relatively large reticulocytes during the recovery process of anemia raises RDW in the case of slowly progressing anemia. RDW has recently been reported to also be an inflammatory indicator. There is mounting evidence linking elevated RDW and adverse outcomes in cardiac disease (2-4), pulmonary embolism (5), trauma (6), septic shock (7), acute pancreatitis (8), hepatitis (9), stroke (10), dementia (11), metabolic syndrome (12), and respiratory diseases such as non-small cell lung cancer (NSCLC) (13,14), chronic obstructive pulmonary disease (15), interstitial pneumonia (16) and sarcoidosis (17). High RDW has been associated with increased mortality and poor pulmonary function also in the general population (18)(19)(20).The aim of this study was to investigate the prognostic impact of RDW on outcomes in elderly patients after surgery for NSCLC. Methods Patient cohortA total of 1,061 patients with NSCLC who underwent resection at our institute between 1998 and 2012 were retrospectively analyzed. Before the study, the Research Review Board of Tokyo University examined and approved our research protocol in accordance with the Declaration of Helsinki (project approval No. 2406). All patients undergoing surgery irrespective of this study provided written informed consent for the review of their medical charts before the surgery. A total of 69...

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“…RDW values increase in anemia, acute blood loss, transfusion, active or chronic inflammatory state, and renal dysfunction. 28 29 Also, the distribution of RDW values is narrow, which limits clinical application. Therefore, high RDW values alone should not be regarded as a single risk factor for poor clinical outcomes in patients with AF.…”

Section: Discussionmentioning

confidence: 99%

Role of Red Cell Distribution Width in the Relationship between Clinical Outcomes and Anticoagulation Response in Patients with Atrial Fibrillation

et al. 2018

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Little is known as to why elevated red cell distribution width (RDW) is associated with adverse clinical outcomes in patients with atrial fibrillation (AF). We hypothesized that RDW value might predict the intensity of anticoagulation, resulting in higher adverse events in patients with AF taking warfarin. We analyzed 657 patients with non-valuvular AF who took warfarin. The intensity of anticoagulation was assessed as mean time in the therapeutic range (TTR) and defined TTR ≥60% as an optimal intensity. The primary end-point was the composite of stroke/systemic embolism and major bleeding. The secondary end-point was the composite of stroke/systemic embolism, major bleeding and death. The relationship between the baseline RDW with TTR and clinical outcomes was assessed using categorical variables as quartiles or dichotomous variables. The mean value of TTR decreased as an increment of the RDW (45.2% vs. 44.7% vs. 40.8% vs. 35.2%, p<0.001). Primary and secondary end-points were significantly increased when TTR was less than 60% and RDW was more than 13.6%. Ratio of patients achieving optimal anticoagulation were significantly decreased as an increment of RDW. A RDW of ≥13.6% was a significant predictor for poor anticoagulation control (adjusted Odds ratio [OR] 0.43, 95% confidence interval [CI] 0.23–0.82), stroke (adjusted hazard ratio [HR] 3.86, 95% CI 1.11–13.40), primary (adjusted HR 1.88, 95% CI 1.12–3.16) and secondary end-point (adjusted HR 2.46, 95% CI 1.26–4.81). RDW was negatively associated with TTR in patients with AF. Therefore, RDW might be a useful marker for the prediction of anticoagulation response and clinical outcomes in patients with AF.

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Red cell distribution width in patients with atrial fibrillation

Cited by 4 publications

References 11 publications

The relationship between elevated red cell distribution width and long-term outcomes among patients with atrial fibrillation

The relationship between elevated red cell distribution width and long-term outcomes among patients with atrial fibrillation

Prognostic significance of red cell distribution width in elderly patients undergoing resection for non-small cell lung cancer

Role of Red Cell Distribution Width in the Relationship between Clinical Outcomes and Anticoagulation Response in Patients with Atrial Fibrillation

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