title: Elevated plasma levels of B-type natriuretic Peptide but not C-reactive protein are associated with higher red cell distribution width in patients with coronary artery disease.
abstract: Although higher red cell distribution width (RDW) has recently been reported to be associated with increased mortality independent of anemia in patients with heart failure and those with coronary artery disease (CAD), the mechanism underlying this association is unknown. We hypothesized that higher RDW may reflect neurohumoral activation and a chronic inflammatory state that each contribute to adverse clinical outcomes in these populations. We measured RDW and plasma levels of B-type natriuretic peptide (BNP) and high-sensitive C-reactive protein (hs-CRP) in 226 consecutive patients undergoing cardiac catheterization for CAD (age, 67 +/- 8 years; males, 77%; RDW, 45.8 +/- 3.3 fL; hemoglobin, 13.2 +/- 1.4 g/dL; BNP, median [interquartile range], 26.0 [9.0-58.4] pg/mL; hs-CRP, 679 [345-1920] ng/mL). Plasma BNP (r = 0.21, P < 0.01) but not hs-CRP (r = 0.04, P > 0.1) levels correlated with RDW. After adjustment for potential confounders including age, gender, body mass index, glomerular filtration rate, hemoglobin, and known hemodynamic determinants of BNP, including elevated left ventricular end-diastolic pressure and volume and slow left ventricular relaxation, RDW was independently predicted by BNP (r(2) = 0.058, P < 0.001). In conclusion, elevated BNP levels are independently associated with higher RDW in patients with CAD. Neurohumoral activation may be a mechanistic link between increased RDW and adverse clinical outcomes in this population.
authors.affiliation: Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
authors.forename: Hidekatsu
authors.initials: H
authors.lastname: Fukuta
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ohte
authors.forename: Seiji
authors.initials: S
authors.lastname: Mukai
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Saeki
authors.forename: Kaoru
authors.initials: K
authors.lastname: Asada
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Wakami
authors.forename: Genjiro
authors.initials: G
authors.lastname: Kimura
mesh_terms: D000368:Aged; D001772:Blood Cell Count; D002097:C-Reactive Protein / Q000378:metabolism*; D006328:Cardiac Catheterization; D048429:Cell Size; D003324:Coronary Artery Disease / Q000097:blood* / Q000401:mortality; D004909:Erythrocyte Indices; D004921:Erythropoietin / Q000097:blood; D005260:Female; D005293:Ferritins / Q000097:blood; D005919:Glomerular Filtration Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis; D012016:Reference Values; D013223:Statistics as Topic; D015996:Survival Rate
chemical_list: D004921:Erythropoietin; D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein; D005293:Ferritins