Red cell distribution width: an inexpensive and powerful prognostic marker in heart failure

医学 红细胞分布宽度 四分位数 心力衰竭 内科学 心脏病学 比例危险模型 病态的 人口 利钠肽 置信区间 环境卫生
作者
Yahya Al‐Najjar,Kevin Goode,Jufen Zhang,John G.F. Cleland,Andrew L. Clark
出处
期刊:European Journal of Heart Failure [Wiley]
卷期号:11 (12): 1155-1162 被引量:163
标识
DOI:10.1093/eurjhf/hfp147
摘要

Aims Red cell distribution width (RDW) is prognostic in patients with heart failure (HF), but it has not been compared with N‐terminal brain natriuretic peptide (NT‐proBNP). We sought to make this comparison. Methods and results Patients referred to a specialist HF clinic between 2001 and 2008 were assessed comprehensively including medical history, echocardiogram, and blood tests. Cox‐regression was used to assess the multivariable relationship between RDW, NT‐proBNP, and all‐cause mortality. A total of 1087 patients were recruited; median (IQR) follow‐up was 52 months (29–66); age 72 years (64–78); 74% male; 70% ischaemic heart disease; 20% diabetic; 85% NYHA ≥ 2, and 63% with at least moderate LV impairment (EF < 35% equivalent). In a multivariable model, both RDW and NT‐proBNP were independently prognostic (RDW: χ 2 = 21.8 vs. 49.1 both P < 0.001). In a model using quartiles of each variable, the relative risk for each was similar for the second and third quartiles compared with the first. A larger increase in risk for NT‐proBNP is seen in the fourth quartile. Conclusion Red cell distribution width is a readily available test in the HF‐population with similar independent prognostic power to NT‐proBNP across the first to third quartiles. Prognostic models in HF should include RDW and further investigation is necessary to determine the pathological mechanism of the relationship.
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