Prognostic value of change in red cell distribution width 1 month after discharge in acute decompensated heart failure patients.
BACKGROUND
Red cell distribution width (RDW) is a novel prognostic marker independently associated with adverse outcomes in acute decompensated heart failure (ADHF) patients. The aim of the present study was to assess whether the change in RDW after discharge had prognostic value in patients with ADHF.


RESULTS
RDW was measured in 261 patients admitted with ADHF, at admission and at discharge and 1 month after discharge. Cardiovascular (CV) events were defined as CV mortality and heart failure rehospitalization. Kaplan-Meier analysis showed that patients with positive RDW change between admission and 1 month after discharge (RDWΔ(1Mdis-adm); n=136) had a significantly higher number of CV events compared with patients with no positive RDWΔ(1Mdis-adm) (n=125; 60.3% vs. 47.2%, log-rank: P=0.007). On Cox hazards analysis, a positive RDWΔ(1Mdis-adm) was an independent predictor of CV events after adjusting for other CV risk factors (hazard ratio, 1.740; 95% confidence interval: 1.149-2.633, P=0.009).


CONCLUSIONS
A novel relationship was noted between positive RDWΔ(1Mdis-adm) and CV events in ADHF patients. Measurement of RDW at 1 month after ADHF assists in the prediction of adverse CV outcomes. Therefore, repeated measurement of RDW is a simple and inexpensive method that may facilitate assessment of CV risk stratification in patients with ADHF.
Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Jaewon
J
Oh
Seok-Min
SM
Kang
Hoyoun
H
Won
Namki
N
Hong
Soo-Young
SY
Kim
Sungha
S
Park
Sang-Hak
SH
Lee
Yangsoo
Y
Jang
Namsik
N
Chung
D000208:Acute Disease; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology; D004912:Erythrocytes / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010351:Patient Discharge; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain