scholarly journals The impact of admission red cell distribution width on long-term cardiovascular events after primary percutaneous intervention: A four-year prospective study

2016 ◽  
Vol 23 (3) ◽  
pp. 281-288 ◽  
Author(s):  
Turgay Isik ◽  
Mustafa Kurt ◽  
Ibrahim Halil Tanboga ◽  
Erkan Ayhan ◽  
Zeki Yuksel Gunaydin ◽  
...  
Keyword(s):  
Prospective Study ◽  
Cardiovascular Events ◽  
Percutaneous Intervention ◽  
Red Cell Distribution Width ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
The Impact ◽  
Primary Percutaneous Intervention

Red cell distribution width (RDW) as a predictor of long-term mortality in patients undergoing percutaneous coronary intervention

2009 ◽  
Vol 102 (09) ◽  
pp. 581-587 ◽  
Author(s):  
Shyam Poludasu ◽  
Jonathan D. Marmur ◽  
Jeremy Weedon ◽  
Waqas Khan ◽  
Erdal Cavusoglu
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Independent Predictor ◽  
Coronary Intervention ◽  
Red Cell Distribution Width ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Percutaneous Coronary ◽  
Long Term Mortality

SummaryRed cell distribution width (RDW) has been shown to be an independent predictor of mortality in patients with coronary artery disease and in patients with heart failure. The current study evaluated the prognostic utility of RDW in patients undergoing percutaneous coronary intervention (PCI). We evaluated 859 patients who underwent PCI during January 2003 to August 2005. After a median follow up of four (interquartile range 3.1 to 4.4) years, there were a total of 95 (11%) deaths. RDW was analysed as a categorical variable with empirically determined cut points of 13.3 and 15.7 (low RDW <13.3, medium RDW ≥13.3 to <15.7, high RDW ≥15.7) based on differences in hazard ratio (HR) for death among RDW deciles.In univariate analysis, higher RDW was a significant predictor of mortality (p<0.001). In multivariate analysis there was a significant two-way interaction between RDW and haemoglobin (Hgb). RDW was not an independent predictor of mortality in patients with Hgb <10.4. However, among patients with Hgb >10.4, high RDW was a strong and independent predictor of mortality. For patients with Hgb ≥10.4 to <12.7, HR for death in patients with high RDW relative to low RDW was 5.2 (95% confidence intervals [CI]: 2.0–13.3). For patients with Hgb ≥12.7, HR for death in patients with high RDW relative to low RDW was 8.6 (CI:2.8–28.6). Higher RDW was a strong and independent predictor of long-term mortality in patients undergoing PCI who were not anaemic at baseline.

Traceable Red Cell Distribution Width Modifications Are Observed Prior to MDS Diagnosis and Primarily Associated with Cardiovascular Organ Dysfunction

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5537-5537
Author(s):  
Claudia Rodriguez ◽  
Alcedo Pedro ◽  
Sarvari Venkata Yellapragada ◽  
Martha P. Mims ◽  
Gustavo A. Rivero
Keyword(s):  
Linear Regression ◽  
Conflicts Of Interest ◽  
Left Ventricular ◽  
Red Cell Distribution Width ◽  
Comorbid Condition ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Clonal Hematopoiesis ◽  
The Impact

Abstract Background: Clonal hematopoiesis in elderly patients without evidence for overt hematologic malignancy (i.e., myelodysplastic syndrome [MDS] and acute leukemia) is associated with elevated Red-Cell-Distribution-Width (RDW). A correlation between high RDW, detectable myeloid mutation and cardiovascular dysfunction (CVD) suggests that inflammation is central to development of clonal hemopoieisis and cardiovascular disease. Anemia, especially linked with elevated RDW is frequently observed in patients with CVD (congestive heart failure [CHF], coronary artery disease [CAD]). Animal models suggest that increased TNFα and activated lymphocytes lead to stem/progenitor hemopoeitic failure during CHF exacerbation. Despite a well-known effect of comorbidities on MDS outcome, the impact of CVD on erythropoiesis prior to development of overt MDS remains uncharacterized. We reasoned that inflammation originating from CVD could not only direct progressive chronic RDW change prior MDS diagnosis but also that those RDW modifications could differ from subgroup of pts without CVD. Methods: RDW data leading up to the diagnosis of MDS was collected retrospectively from79 patients stratified according to MDS-comorbidity index. Patients were analyzed to determine if comorbidity was present at the time of first detectable RDW abnormality. Datapoints suggesting GI bleed, hemolytic anemia, thalassemia trait, iron and B12 deficiencies were excluded. Timescales were designed to record, in each pt, first detectable RDW followed by all available time- aligned datapoints until the time of diagnosis. The presence of left ventricular dysfunction, CAD and either CHF or CAD associated with atrial fibrillation were considered CVD. Pt with non-CVD comorbid condition (CC) or without comorbidity were assigned to the non-CVD subgroup. A linear regression model was used to evaluate correlation between RDW modifications and time-progression prior to MDS diagnosis. R-squared calculations allowed investigation for strength of association between observed RDW means and fitted regression line among pts with and without CVD. Results: Disease characteristics among pts with and without CVD are depicted in table 1. Age, blast count, and R-IPSS subgroups were balanced in both groups. Hemoglobin for pts with and without CVD was 8.8 g/dL vs 9.75 g/dL, respectively (p=0.04). For pt with evidence of CVD, higher platelet count was observed (146 K/uL and 110.5 K/uL, respectively, p= 0.0007). Linear regression revealed that RDW modifications co-evolve overtime in pts with and without CVD (p=0.0001 for both groups) Fig 1. However, a stronger association between time evolution and RDW modifications was observed in pt with CVD vs those without CVD (R2 =.66% vs 0.61%, respectively) Conclusion: Progressive RDW modifications occur months to years before MDS diagnosis. Sequential time-dependent RDW modifications in pts with CC suggest a link between defects in erythropoiesis and comorbidity prior MDS diagnosis. Our results support the view that evolutionary RDW modifications underpin the capacity of hemopoieitic stem cells to adapt to adverse organ function, especially in pt diagnosed with CVD experiencing anemia. Our study represents a conceptual framework for investigation of the initiation of clonal hematopoiesis in an aging population with CVD. Disclosures No relevant conflicts of interest to declare.

Sign in / Sign up

Export Citation Format

Share Document