Red cell distribution width predicts short- and long-term outcomes of acute congestive heart failure more effectively than hemoglobin

Abstract

The present study compared short- and long-term prognostic values of red blood cell distribution width (RDW) with those of hemoglobin (Hgb) among patients with acute congestive heart failure (CHF) in a cardiac care unit. The cross-sectional study examined data from 521 patients with acute CHF who were admitted to a cardiac care unit and followed up for 24 months (median). Mean Hgb levels in patients who succumbed (DIH) or remained alive (AIH) were 11.0±1.8 and 11.8±2.6 g/l (P>0.05), respectively. Median values of RDW were 16.2% and 14.4%, respectively (P<0.0001). During the 24-month follow-up, mean levels of Hgb in groups with and without endpoints were 11.4±2.5 and 12.5±2.4 g/dl (P<0.0001), respectively. Median RDW values were 14.9 and 13.8%, respectively (P<0.0001). Logistic regression analysis showed that in-hospital mortality was significantly associated with RDW (P=0.044), New York Heart Association (NYHA) functional class IV (P=0.0037), estimated glomerular filtration rate (eGFR) (P=0.042) and C-reactive protein (P=0.0044), but not with Hgb (P=0.10). The multivariate Cox proportional hazard model selected RDW [hazard ratio (HR), 2.19; P<0.0001], left ventricular ejection fraction (HR 0.81, P=0.0016), age (10-year increase; HR 1.19, P=0.0017) and NYHA functional classes III/IV (HR 1.52, P=0.0029) as independent predictors of long-term outcomes after adjustment, but not Hgb (HR 1.01, P=0.86). Higher RDW values in acute CHF patients at admission were associated with worse short- and long-term outcomes and RDW values were more prognostically relevant than Hgb levels.

Ancestry-specific associations identified in genome-wide combined-phenotype study of red blood cell traits emphasize benefits of diversity in genomics

“…In the average adult, 200 billion red blood cells (RBCs) are generated daily from hematopoietic stem cells in the bone marrow. The most commonly assessed traits for mature RBCs are hematocrit (HCT), hemoglobin concentration (HGB), mean corpuscular hemoglobin (MCH), MCH concentration (MCHC), mean corpuscular volume (MCV), RBC count (RBCC), and red cell distribution width (RDW); together, these traits are used to characterize RBC development and function, diagnose anemic disorders, and identify risk factors for complex chronic diseases [1][2][3][4][5][6]. RBC traits also are moderately to highly heritable, making these complex quantitative traits excellent candidates for genomic interrogation [7][8][9].…”

Ancho de distribución eritrocitaria como potencial biomarcador clínico en enfermedades cardiovasculares

“…Una serie de estudios han demostrado que el RDW predice en forma significativa la presencia y severidad de ECV en pacientes con IC [17][18][19] , infarto agudo al miocardio (IAM) previo [20][21][22] y fibrilación auricular 23 . En relación a la IC, diversos estudios desde el publicado por Felker y cols., han mostrado una relación positiva entre el RDW y diferentes pará-metros como grado funcional de la NYHA 17 , readmisiones hospitalarias 18 , y péptido natriurético tipo B (BNP) 19 .…”

“…En relación a la IC, diversos estudios desde el publicado por Felker y cols., han mostrado una relación positiva entre el RDW y diferentes pará-metros como grado funcional de la NYHA 17 , readmisiones hospitalarias 18 , y péptido natriurético tipo B (BNP) 19 . En relación a este último marcador sanguíneo altamente estudiado en la IC, se ha reportado una robusta asociación entre el aumento del RDW y el BNP.…”

Prognostic significance of red cell distribution width and its relation to increased pulmonary pressure and inflammation in acute heart failure

“…Among them, red cell distribution width (RDW) was found to be the cheapest and most widely available indicator. The RDW was established to be a strong predictor of mortality in the general population above 45 years of age [2], as well as during sepsis, trauma and in critically ill patients [3][4][5]. Several studies confirmed that RDW predicts mortality in acute and chronic heart failure (CHF) [5][6][7][8][9].…”

“…The RDW was established to be a strong predictor of mortality in the general population above 45 years of age [2], as well as during sepsis, trauma and in critically ill patients [3][4][5]. Several studies confirmed that RDW predicts mortality in acute and chronic heart failure (CHF) [5][6][7][8][9]. It was reported that an increasing RDW value is associated with cytokine activation, impaired iron mobilization and decreased hemoglobin (Hb) levels [10][11][12].…”