Red cell distribution width in relation to incidence of coronary events and case fatality rates: a population-based cohort study.
OBJECTIVE
High red cell distribution width (RDW) is a strong prognostic factor in patients with cardiovascular disease. We investigated the association between RDW and incidence of acute coronary events (CEs) and fatal outcome in subjects who subsequently experienced a first CE.


RESULTS
RDW was measured in 26 820 subjects (aged 45-73 years, 61.6% women), without history of myocardial infarction or stroke, who participated in the Malmö Diet and Cancer study during 1991-1996. Cox proportional hazards model was used to analyse the association between RDW and CE. During a mean follow-up of 14 years, 1995 subjects had a first CE, of which 415 subjects died on the same day as the CE (fatal on day 1), another 86 died within 28 days (fatal in 28 days) and 1494 were non-fatal (survived >28 days). After adjustment for risk factors, baseline RDW was significantly associated with incidence of fatal CE (HR 1.82, CI 1.35 to 2.44) but not with non-fatal CE (HR 0.96, CI 0.82 to 1.12). Among all subjects with a CE during follow-up, the proportion who died on day 1 was 13.7%, 18.2%, 22.5% and 26.7%, respectively, for first, second, third and fourth quartiles of RDW.


CONCLUSIONS
In this population-based study of subjects without history of CE or stroke, high RDW was associated with increased incidence of fatal CE. No relationship was observed for incidence of non-fatal CE.
Department of Clinical Sciences, Lund University, Skåne University hospital, Malmö, Sweden.
Yan
Y
Borné
Department of Clinical Sciences, Lund University, Skåne University hospital, Malmö, Sweden Department of Cardiology, Lund University, Skåne University Hospital, Lund, Sweden Program of Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.
J Gustav
JG
Smith
Department of Clinical Sciences, Lund University, Skåne University hospital, Malmö, Sweden.
Olle
O
Melander
Department of Clinical Sciences, Lund University, Skåne University hospital, Malmö, Sweden.
Gunnar
G
Engström
D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D004909:Erythrocyte Indices; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology; D055105:Waist Circumference
CORONARY ARTERY DISEASE