Impact of red cell distribution width on outcome of 16 681 patients with chronic systolic heart failure
10.3760/cma.j.issn.0253-3758.2012.03.012
- VernacularTitle:慢性收缩性心力衰竭患者红细胞分布宽度对预后的预测价值及相关因素分析
- Author:
Sheng-Bo YU
1
;
Hong-Ying CUI
;
Mu QIN
;
Tao LIU
;
Bin KONG
;
Qing-Yan ZHAO
;
He HUANG
;
Cong-Xin HUANG
Author Information
1. 武汉大学人民医院
- Keywords:
Heart failure,congestive;
Erythrocytes;
Prognosis
- From:
Chinese Journal of Cardiology
2012;40(3):237-242
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determinate the prognostic value of red cell distribution width (RDW) and the relationships between RDW and clinical characteristics in patients with chronic heart failure (CHF).Methods A total of 16 681 in-hospital patients with chronic systolic HF and LVEF ＜50％ from 12 hospitals in Hubei province,China were enrolled.All patients were followed up with telephone call.Patients were divided into RDW ≤ 13.2％ (n =3981 ),13.3％ - 14.1％ (n =3996),14.2％ - 14.8％ ( n =4319) and ≥14.9％ (n =4385 )groups.Multivariate Cox regression analysis was performed to determine whether RDW is an independent risk factor of all-cause mortality in overall patients,patients with various etiologies.Multivariate Cox proportional hazard analysis was performed to determine the risk of all-cause mortality among various RDW groups.Results ( 1 ) Compared with RDW ≤ 13.2％ group,adjusted hazard ratios (HRs) and 95％ confidence intervals (CIs) of all-cause mortality for RDW 13.3％ -14.1％,14.2％ -14.8％ and ≥ 14.9％ were 0.892 (95 ％ CI 0.818-0.973,P =0.01 ),0.859 (95 ％ CI 0.793 -0.931,P ＜0.01) and 1.034 (95％ CI 0.961 - 1.111,P =0.373) respectively. (2) Compared with MCV normal group,the adjusted HRs of MCV elevation and MCV decline groups were 1.351 (95％ CI 1.063 - 1.718,P ＜0.01 ) and 1.316 (95％ CI 1.034 - 1.675,P ＜ 0.01 ),respectively.(3) Compared to patients with rheumatic heart diseases,the adjusted HR for all-cause mortality in patients with coronary heart disease,dilated cardiomyopathy and hypertensive heart disease with RDW ＞ 16％ were 1.437 (95％ CI 1.141 -1.810,P＜0.01),1.651 (95％ CI 1.276 -2.138,P＜0.01) and 1.276 (95％ CI 1.004- 1.621,P ＜ 0.01 ),respectively.(4) The RDW is independently correlated with BMI ( r =- 0.345,P ＜ 0.01 ),diastolic blood pressure( r =- 0.321,P ＜ 0.01 ),albumin ( r =- 0.411,P ＜ 0.01 ),blood urine nitrogen ( r =0.476,P ＜ 0.01 ),right ventricular end-diastolic diameter( r =0.383,P ＜ 0.01 ),LVEF ( r =- 0.463,P ＜0.01 ) and heart rate( r =0.379,P ＜0.01 ).Conclusions There is a J shape relationship between allcause mortality and RDW.The elevation or decline of MCV with increased RDW is hnked with increased allcause mortality in CHF patients.
