title: Red cell distribution width, C-reactive protein, the complete blood count, and mortality in patients with coronary disease and a normal comparison population.
abstract: BACKGROUND
  Red cell distribution width (RDW) is associated with morbidity and mortality in coronary artery disease (CAD), but the connection of RDW with chronic inflammation is equivocal.
  
  
  METHODS
  In 1,489 patients with CAD and 8.4-15.2 years of follow-up all-cause mortality and RDW were studied using Cox regression. RDW and its associations with inflammation, liver function, renal function, and body mass were assessed. A population of 449 normal (No-CAD) patients also was evaluated.
  
  
  RESULTS
  RDW predicted all-cause mortality in a step-wise manner (HR=1.37 per quintile; 95% CI=1.29, 1.46; p-trend<0.001). A significant but meaningless correlation between RDW and high-sensitivity C-reactive protein (hsCRP) was identified (r=0.181; p<0.001). With full adjustment, RDW remained significant (p-trend<0.001) and the strongest predictor of mortality among all factors included in the model. RDW also strongly predicted all-cause mortality in the normal control population (HR=1.33 per quintile, CI=1.15, 1.55; p-trend<0.001), but hsCRP did not predict mortality among normal controls.
  
  
  CONCLUSIONS
  RDW was associated with mortality in patients with CAD and may provide clinically useful prognostication. Although RDW was correlated with hsCRP, they were independent predictors of mortality. RDW has been incorporated into risk prediction tool using data from basic chemistries available at: http://intermountainhealthcare.org/IMRS.
authors.affiliation: Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, NC, USA.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Lappé
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Horne
authors.forename: Svati H
authors.initials: SH
authors.lastname: Shah
authors.forename: Heidi T
authors.initials: HT
authors.lastname: May
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Muhlestein
authors.forename: Donald L
authors.initials: DL
authors.lastname: Lappé
authors.forename: Abdallah G
authors.initials: AG
authors.lastname: Kfoury
authors.forename: John F
authors.initials: JF
authors.lastname: Carlquist
authors.forename: Deborah
authors.initials: D
authors.lastname: Budge
authors.forename: Rami
authors.initials: R
authors.lastname: Alharethi
authors.forename: Tami L
authors.initials: TL
authors.lastname: Bair
authors.forename: William E
authors.initials: WE
authors.lastname: Kraus
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Anderson
mesh_terms: D000368:Aged; D001772:Blood Cell Count; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D003327:Coronary Disease / Q000097:blood* / Q000401:mortality; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models
chemical_list: D002097:C-Reactive Protein