title: Red cell distribution width predicts mortality in infective endocarditis.
abstract: BACKGROUND
  Infective endocarditis (IE) is associated with significant morbidity and mortality. Red cell distribution width (RDW) is a recently recognized biomarker of adverse outcome in a number of acute and chronic conditions.
  
  
  OBJECTIVE
  To investigate the relationship between RDW and 1-year survival in patients with IE.
  
  
  METHODS
  Clinical records from two tertiary centres were used to analyze data from patients with definite IE. Clinical, echocardiographic and biochemical variables were evaluated along with RDW. One-year survival status after index hospitalization was identified for each patient.
  
  
  RESULTS
  One hundred consecutive patients (mean age 47.8±16.7 years; 61% men) with definite IE were enrolled. According to receiver operating characteristic curve analysis, the optimal RDW cut-off value for predicting mortality was 15.3% (area under the curve 0.70; P=0.001). Forty-one patients (41%) died within 1 year; of these, 88% had RDW results>15.3%. Univariate Cox proportional-hazards analysis showed that RDW>15.3%, heart failure, renal failure, cardiac abscess, severe valvular regurgitation and presence of dehiscence were associated with increased mortality. Multivariable Cox proportional-hazards analysis revealed that renal failure (hazard ratio [HR] 3.21, 95% confidence interval [CI] 1.35-7.59; P=0.008), heart failure (HR 2.77, 95% CI 1.1-6.97; P=0.03) and RDW>15.3% (HR 3.07, 95% CI 1.06-8.86; P=0.03) were independent predictors of mortality in patients with IE.
  
  
  CONCLUSIONS
  According to our results, mortality is high in patients with IE. RDW is a promising biomarker for predicting 1-year survival rates in these patients.
authors.affiliation: Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Yesim
authors.initials: Y
authors.lastname: Guray
authors.affiliation: Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey. Electronic address: esragucuk@hotmail.com.
authors.forename: Esra Gucuk
authors.initials: EG
authors.lastname: Ipek
authors.affiliation: Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Umit
authors.initials: U
authors.lastname: Guray
authors.affiliation: Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Demirkan
authors.affiliation: Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Habibe
authors.initials: H
authors.lastname: Kafes
authors.affiliation: Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Lale Dinc
authors.initials: LD
authors.lastname: Asarcikli
authors.affiliation: Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Gizem
authors.initials: G
authors.lastname: Cabuk
authors.affiliation: Cumhuriyet University Faculty of Medicine, Department of Cardiology, Sivas, Turkey.
authors.forename: Mehmet Birhan
authors.initials: MB
authors.lastname: Yilmaz
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000453:epidemiology; D019540:Area Under Curve; D002318:Cardiovascular Diseases / Q000453:epidemiology; D004697:Endocarditis, Bacterial / Q000097:blood* / Q000401:mortality / Q000601:surgery; D004909:Erythrocyte Indices; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006439:Hemodynamics; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D016459:Prosthesis-Related Infections / Q000097:blood / Q000382:microbiology / Q000401:mortality / Q000601:surgery; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D014421:Turkey / Q000453:epidemiology
keywords: Distribution érythrocytaire; Endocardite infectieuse; Infective endocarditis; Outcome; Red cell distribution width; Suivi