Elevation of red blood cell distribution width during hospitalization predicts mortality in patients with acute decompensated heart failure

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• 作者：Yusuke Uemura ; MD ; PhD^a ; ^{yusuke0307@kosei.anjo.aichi.jp" class="auth_mail" title="E-mail the corresponding author} ; Rei Shibata ; MD ; PhD^b ; Kenji Takemoto ; MD ; PhD^a ; Tomohiro Uchikawa ; MD^a ; Masayoshi Koyasu ; MD^a ; Hiroki Watanabe ; MD^a ; Takayuki Mitsuda ; MD^a ; Ayako Miura ; MD^a ; Ryo Imai ; MD^a ; Masato Watarai ; MD ; PhD^a ; Toyoaki Murohara ; MD ; PhD^b
• 关键词：Red blood cell distribution width ; Acute decompensated heart failure ; Mortality
• 刊名：Journal of Cardiology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：67
• 期：3
• 页码：268-273
• 全文大小：344 K

文摘

Increased red blood cell distribution width (RDW) is associated with adverse outcomes in heart failure. In the present study, we assessed the association between changes in RDW values during hospitalization and long-term prognosis in patients with acute decompensated heart failure (ADHF).

Methods

We measured the RDW value in 229 consecutive patients with ADHF. Blood samples were obtained at the time of hospital admission and at discharge. Changes in RDW were calculated as the mean difference between RDW values on admission and those at the time of hospital discharge.

Results

Patients were followed up for a median of 692 days. A Kaplan–Meier survival analysis demonstrated that patients whose RDW levels increased during hospitalization had significantly higher all-cause and cardiac-based mortality following heart failure than did patients whose RDW levels decreased during hospitalization. A multivariate Cox regression analysis revealed that change in RDW values during hospitalization, but not the values of RDW and hemoglobin on admission, was independently correlated with all-cause and cardiac-based mortality after adjusting for other risk factors in patients with ADHF.

Conclusions

These data document that the change in RDW values during hospitalization independently predicts poor outcomes in patients with ADHF. Continuous follow-up of RDW values could provide useful information for long-term prognosis after heart failure.