Red Cell Distribution Width Is an Independent Predictor of 1-Year Mortality in a Turkish Patient Population with Acute Decompensated Heart Failure

Umit Yuksek

doi:10.58600/eurjther1803

Authors

Umit Yuksek Department of Cardiology, Odemis State Hospital, Izmir, Turkey https://orcid.org/0000-0003-3435-6788

DOI:

https://doi.org/10.58600/eurjther1803

Keywords:

Red cell distribution width, mortality, heart failure

Abstract

Objective: Heart failure (HF) is a significant public health issue in Turkey. The goal of this study was to look into how red cell distribution width (RDW) affected patients with acute decompensated HF (ADHF) patients' prognoses.

Methods: A total of 101 ADHF patients under the age of 18 were enrolled in the study. Venous blood was drawn to measure the serum rdw. After a year of follow-up, the patients' survival status was determined.

Results: The patients' mean age was 72. Forty-nine patients had heart failure (HF) with a reduced ejection fraction (EF), 8 had HF with a mildly reduced EF, and 44 had HF with a preserved EF. The median RDW value was 15.9%. In the hospital, nine patients passed away, and 92 others were discharged. 14 patients were lost to follow-up after one year, 87 patients completed the trial, and 40 patients passed away. Inotropic medication use, and serum RDW value were identified as independent predictors of 1-year death in ADHF patients by multivariate logistic regression analysis. According to this data, there was a 44% increase in 1-year mortality for every 1% increase in RDW.

Conclusion: In Turkish patients hospitalized for ADHF, red cell distribution width represents an independent prognostic predictor for 1-year mortality.

Metrics

Metrics Loading ...

References

Degertekin M, Erol C, Ergene O, Tokgozoglu L, Aksoy M, Erol MK, Eren M, Sahin M, Eroglu E, Mutlu B, Kozan O (2012) Heart failure prevalence and predictors in Turkey: HAPPY study. Arch Turk Soc Cardiol. 40(4):298-308.([In Turkish]) https://doi.org/10.5543/tkda.2012.65031

Yilmaz MB, Aksakal E, Aksu U, Altay H, Yıldırım N, Celik A, Akil MA, Bekar L, Vural MG, Guvenc RC, Ozer S, Ural D, Cavusoglu Y, Tokgozoglu L (2020) Snapshot evaluation of acute and chronic heart failure in real-life in Turkey: A follow-up data for mortality. Anatol J Cardiol. 23(3):160-168. https://doi.org/10.14744/AnatolJCardiol.2019.87894

Crespo-Leiro-MG, Anker SD, Maggioni AP, Coats AJ, Filippatos G, Ruschitzka F, Ferrari R, Piepoli MF, Jimenez JFD, Metra M, Fonseca C, Hradec J, Amir O, Logeart D, Dahlström U, Merkely B, Drozdz J, Goncalvesova E, Hassanein M, Chioncel O, Lainscak M, Seferovic PM, Tousoulis D, Kavoliuniene A, Fruhwald F, Fazlibegovic E, Temizhan A, Gatzov P, Erglis A, Laroche C, Mebazaa A; Heart Failure Association (HFA) of the European Society of Cardiology (ESC) (2016) European society of cardiology heart failure long-term registry (ESC-HF-LT): 1-year-follow-up outcomes and difference across regions. Eur J Heart Fail. 18(6):613-625. https://doi.org/10.1002/ejhf.566

Pocock SJ, Ariti CA, McMurray JJV, Maggioni A, Kober L, Squire IB, Swedberg K, Dobson J, Poppe KK, Whalley GA, Doughty RN; Meta-Analysis Global Group in Chronic Heart Failure (2013) Predicting survival in heart failure: a risk score based on 39 372 patients from 30 studies. Eur Heart J. 34(19):1404-1413. https://doi.org/10.1093/eurheartj/ehs337

Rahimi K, Bennett D, Conrad N, Williams TM, Basu J, Dwight J, Woodward M, Patel A, McMurray J, MacMahon S (2014) Risk prediction in patients with heart failure: a systematic review and analysis. JACC Heart Fail.2(5):440-446. https://doi.org/10.1016/j.jchf.2014.04.008

Ouwerkerk W, Voors AA, Zwinderman AH (2014) Factors influencing the predictive power of models for predicting mortality and/or heart failure hospitalization in patients with heart failure. JACC Heart Fail. 2(5):429-436. https://doi.org/10.1016/j.jchf.2014.04.006

Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJV, Pfeffer MA, Swedberg K, Wang D, Yusuf S, Michelson EL, Granger CB; CHARM Investigators (2007) Red cell distribution width as a novel prognostic marker in heart failure data from the CHARM program and duke databank. J Am Coll Cardiol. 50(1):40-47. https://doi.org/10.1016/j.jacc.2007.02.067

van Kimmenade RR, Mohammed AA, Uthamalingam S, van der Meer P, Felker M, Januzzi Jr JL (2010) Red cell distribution width and 1-year mortality in acute heart failure. Eur J Heart Fail. 12(2):129-136. https://doi.org/10.1093/eurjhf/hfp179

Sotiropoulos K, Yerly P, Monney P, Garnier A, Regamey J, Hugli O, Martin D, Metrich M, Antonietti JP, Hullin R (2016) Red cell distribution width and mortality in acute heart failure patients with preserved and reduced ejection fraction. ESC Heart Fail. 3(3):198-204. https://doi.org/10.1002/ehf2.12091

Hou H, Sun T, Li C, Li Y, Guo Z, Wang W, Li D (2017) An overall and dose-response meta-analysis of red blood cell distribution width and CVD outcomes. Sci Rep. 7:43420. https://doi.org/10.1038/srep43420

Jung C, Fujita B, Lauten A, Kiehntopf M, Küthe F, Ferrari M, Figulla HR (2011) Red blood cell distribution width as useful tool to predict long-term mortality in patients with chronic heart failure. Int J Cardiol. 152(3):417-418. https://doi.org/10.1016/j.ijcard.2011.08.052

Förhecz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohaszka Z, Janoskuti L (2009) Red cell distribution width in heart failure: prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J. 158(4):659-666. https://doi.org/10.1016/j.ahj.2009.07.024

Huang YL, Hu ZD, Liu SJ, Sun Y, Qin Q, Qin BD, Zhang WW, Zhang RQ, Deng AM (2014) Prognostic value of red blood cell distribution width for patients with heart failure: a systematic review and meta-analysis of cohort studies. PloS One. 9(8):e104861. https://doi.org/10.1371/journal.pone.0104861

Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer; for the Cholesterol and Recurrent Events (CARE) Trial Investigators (2008) Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation. 117(2):163-168. https://doi.org/10.1161/CIRCULATIONAHA.107.727545

Ferreira JP, Girerd N, Arrigo M, Medeiros PB, Ricardo MB, Almeida T, Rola A, Tolpannen H, Laribi S, Gayat E, Mebazaa A, Mueller C, Zannad F, Rossignol P, Aragao I (2016) Enlarging red blood cell distribution width during hospitalization identifies a very high-risk subset of acutely decompensated heart failure patients and adds valuable prognostic information on top of hemoconcentration. Medicine (Baltimore).95(14):e3307. https://doi.org/ 10.1097/MD.0000000000003307

Turcato G, Zorzi E, Prati D, Ricci G, Bonora A, Zannoni M, Maccagnani A, Salvagno GL, Sanchis-Gomar F, Cervellin G, Lippi G (2017) Early in-hospital variation of red blood cell distribution width predicts mortality in patients with acute heart failure. Int J Cardiol. 243:306-310. https://doi.org/10.1016/j.ijcard.2017.05.023

Jackson CE, Dalzell JR, Bezlyak V, Tsorlalis IK, Myles RC, Spooner R, Ford I, Petrie MC, Cobbe SM, McMurray JJV (2009) Red cell distribution width has incremental prognostic value to B-type natriuretic peptide in acute heart failure. Eur J Heart Fail. 11(12):1152-1154. https://doi.org/10.1093/eurjhf/hfp157

Subramanian M, Prabhu MA, Saravanan S, Thachathodiyl R (2018) Bio-width index: a novel biomarker for prognostication of long term outcomes in patients with anemia and heart failure. Acta Cardiol. 73(4):403-409. https://doi.org/10.1080/00015385.2017.1408890

Patel KV, Semba RD, Ferrucci L, Newman AB, Fried LP, Wallace RB, Bandinelli S, Phillips CS, Yu B, Connelly S, Shlipak MG, Chaves PHM, Launer LJ, Ershler WB, Harris TB, Longo DL, Guralnik JM (2010) Red cell distribution width and mortality in older adults: a meta-analysis. J Gerontol A Biol Sci Med Sci. 65(3):258-265. https://doi.org/10.1093/gerona/glp163

Lippi G, Turcato G, Cervellin G, Sanchis-Gomar F (2018) Red blood cell distribution width in heart failure: A narrative review. World J Cardiol. 10(2):6-14. https://doi.org/10.4330/wjc.v10.i2.6

Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC (2009) Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 133(4):628-632. https://doi.org/10.5858/133.4.628

Shirazi LF, Bissett J, Romeo F, Mehta JL (2017) Role of inflammation in heart failure. Curr Atheroscler Rep. 19(6):27. https://doi.org/10.1007/s11883-017-0660-3

Paolillo S, Scardovi AB, Campodonico J (2020) Role of comorbidities in heart failure prognosis Part I: Anemia, iron deficiency, diabetes, atrial fibrillation. Eur J Prev Cardiol. 27(2 Suppl):27-34. https://doi.org/10.1177/2047487320960288

Makhoul BF, Khourieh A, Kaplan M, Bahouth F, Aronson D, Azzam ZS (2013) Relation between changes in red cell distribution width and clinical outcomes in acute decompensated heart failure. Int J Cardiol. 167(4):1412-1416. https://doi.org/10.1016/j.ijcard.2012.04.065

Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G (2015) Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 52(2):86-105. https://doi.org/10.3109/10408363.2014.992064

Ozcan F, Turak O, Avci S, Tok D, Isleyen A, Aras D, Aydogdu S (2013) Heart rate variability and red cell distribution width in patients with systolic heart failure. Scand Cardiovasc J. 47(4):225-229. https://doi.org/10.3109/14017431.2012.755561

Eroglu E, Kilicgedik A, Kahveci G, Bakal RB, Kirma C (2018) Red cell distribution width and its relationship with global longitudinal strain in patients with heart failure with reduced ejection fraction: a study using two-dimensional speckle tracking echocardiography. Kardiol Pol. 76(3):580-585. https://doi.org/10.5603/KP.a2017.0256

Tkaczyszyn M, Comin-Colet J, Voors AA, Van Veldhuisen DJ, Enjuanes C, Moliner-Borja P, Rozentryt P, Polonski L, Banasiak W, Ponikowski P, Van der Meer P, Jankowska EA (2018) Iron deficiency and red cell indices in patients with heart failure. Eur J Heart Fail. 20(1):114-122. https://doi.org/10.1002/ejhf.820

Shao Q, Li L, Li G, Liu T (2015) Prognostic value of red blood cell distribution width in heart failure patients: a meta-analysis. Int J Cardiol. 179:495-499. https://doi.org/10.1016/j.ijcard.2014.11.042