Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Heart Failure
Red Blood Cell Distribution Width Is Longitudinally Associated With Mortality and Anemia in Heart Failure Patients
Julio NúñezEduardo NúñezDimitris RizopoulosGema MiñanaVicent BodíLourdes BondanzaOliver HusserPilar MerlosEnrique SantasDomingo Pascual-FigalFrancisco J. ChorroJuan Sanchis
Author information
JOURNAL FREE ACCESS
Supplementary material

2014 Volume 78 Issue 2 Pages 410-418

Details
Abstract

Background: Red blood cell distribution width (RDW) has been found to be an independent predictor for adverse outcome in patients with heart failure (HF), but there are no data on the association of longitudinal RDW with all-cause mortality and occurrence of anemia. Methods and Results: 1,702 patients discharged from a previous admission for acute HF (AHF) were included. RDW was measured during the available longitudinal history of the patient. Joint modeling and Multistate Markov were used for the analysis. The median RDW at baseline was 15.0% (IQR: 14.0–16.5), and 45.6% of patients had anemia. At a median follow-up of 1.5 years (IQR: 0.45–3.25), 713 patients died. The last RDW-trajectory value and cumulative RDW-trajectory mean were predictive of mortality (HR, 1.18; 95% CI: 1.12–1.24; and HR, 1.12; 95% CI: 1.08–1.16, respectively; P<0.001 for both). This effect, however, varied according the anemia status (P for interaction<0.001), being more pronounced in absence of anemia [HR=1.31 (95% CI: 1.22–1.42) and HR=1.48 (95% CI: 1.33–1.64)] compared to those with anemia [HR=1.08 (95% CI: 1.04–1.13), 1.12 (95% CI: 1.06–1.18)]. Longitudinal RDW (per 1% increasing) was also independently associated with incident anemia [HR=1.10 (95% CI: 1.03–1.18) P=0.002]. Conclusions: Following an admission for AHF, higher longitudinal RDW values over time were associated to an increased risk for both developing anemia and dying. The effect on mortality was more pronounced among non-anemic patients.  (Circ J 2014; 78: 410–418)

Content from these authors
© 2014 THE JAPANESE CIRCULATION SOCIETY
Previous article Next article
feedback
Top