open access

Vol 25, No 3 (2018)
Original articles — Clinical cardiology
Published online: 2017-03-27
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Prognostic value of red blood cell distribution width in patients with left ventricular systolic dysfunction: Insights from the COMMIT-HF registry

Jarosław Wasilewski, Łukasz Pyka, Michał Hawranek, Mateusz Tajstra, Michał Skrzypek, Michał Wasiak, Kamil Suliga, Kamil Bujak, Mariusz Gąsior
DOI: 10.5603/CJ.a2017.0037
·
Pubmed: 28353308
·
Cardiol J 2018;25(3):377-385.

open access

Vol 25, No 3 (2018)
Original articles — Clinical cardiology
Published online: 2017-03-27

Abstract

Background: Previous studies have reported that in patients with heart failure, an increased value of red cell distribution width (RDW) is associated with adverse outcomes. Nonetheless, data regarding the association between RDW values and long-term mortality in patients with left ventricular systolic dysfunction (LVSD) are lacking. The aim of this investigation was to examine the relationship between mortality and RDW in patients with ischemic and non-ischemic LVSD.

Methods: Under analysis was 1734 patients with a left ventricular ejection fraction (LVEF) ≤ 35% of whom were hospitalized between 2009 and 2013. Patients were divided into three groups based on RDW tertiles. Low, medium and high tertiles were defined as RDW ≤ 13.4%, 13.4% < RDW ≤ 14.6% and RDW > 14.6%, respectively.

Results: There was a stepwise relationship between RDW intervals and comorbidities. Patients with the highest RDW values were older and more often diagnosed with anemia, diabetes, atrial fibrillation and chronic kidney disease. The main finding of our analysis was the presence of an 8-fold increase in all-cause mortality in the entire cohort between high and low RDW tertile. Cox hazard analysis identi­fied RDW as an independent predictive factor of mortality in all patients (HR 2.8; 95% CI 2.1–3.8; p < 0.0001) and in subgroups of patients with ischemic (HR 2.8; 95% CI 2.0–3.9; p < 0.0001) and non-ischemic (HR 3.3; 95% CI 2.01–5.5; p < 0.0001) LVSD.

Conclusions: The highest RDW tertile was independently associated with higher long-term mortality compared with low and medium tertiles, both in all patients with a LVEF ≤ 35% and in subgroups of patients with ischemic and non-ischemic LVSD.

Abstract

Background: Previous studies have reported that in patients with heart failure, an increased value of red cell distribution width (RDW) is associated with adverse outcomes. Nonetheless, data regarding the association between RDW values and long-term mortality in patients with left ventricular systolic dysfunction (LVSD) are lacking. The aim of this investigation was to examine the relationship between mortality and RDW in patients with ischemic and non-ischemic LVSD.

Methods: Under analysis was 1734 patients with a left ventricular ejection fraction (LVEF) ≤ 35% of whom were hospitalized between 2009 and 2013. Patients were divided into three groups based on RDW tertiles. Low, medium and high tertiles were defined as RDW ≤ 13.4%, 13.4% < RDW ≤ 14.6% and RDW > 14.6%, respectively.

Results: There was a stepwise relationship between RDW intervals and comorbidities. Patients with the highest RDW values were older and more often diagnosed with anemia, diabetes, atrial fibrillation and chronic kidney disease. The main finding of our analysis was the presence of an 8-fold increase in all-cause mortality in the entire cohort between high and low RDW tertile. Cox hazard analysis identi­fied RDW as an independent predictive factor of mortality in all patients (HR 2.8; 95% CI 2.1–3.8; p < 0.0001) and in subgroups of patients with ischemic (HR 2.8; 95% CI 2.0–3.9; p < 0.0001) and non-ischemic (HR 3.3; 95% CI 2.01–5.5; p < 0.0001) LVSD.

Conclusions: The highest RDW tertile was independently associated with higher long-term mortality compared with low and medium tertiles, both in all patients with a LVEF ≤ 35% and in subgroups of patients with ischemic and non-ischemic LVSD.

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Keywords

red cell distribution width, heart failure, mortality, iron metabolism disorders, ventricular ejection fraction

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About this article
Title

Prognostic value of red blood cell distribution width in patients with left ventricular systolic dysfunction: Insights from the COMMIT-HF registry

Journal

Cardiology Journal

Issue

Vol 25, No 3 (2018)

Pages

377-385

Published online

2017-03-27

DOI

10.5603/CJ.a2017.0037

Pubmed

28353308

Bibliographic record

Cardiol J 2018;25(3):377-385.

Keywords

red cell distribution width
heart failure
mortality
iron metabolism disorders
ventricular ejection fraction

Authors

Jarosław Wasilewski
Łukasz Pyka
Michał Hawranek
Mateusz Tajstra
Michał Skrzypek
Michał Wasiak
Kamil Suliga
Kamil Bujak
Mariusz Gąsior

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