title: Red cell distribution width is associated with cardiovascular risk and disease parameters in rheumatoid arthritis.
abstract: OBJECTIVE
  Since red cell distribution width (RDW) has been associated with cardiovascular (CV) disease and inflammation in several conditions, the main aim of this study was to evaluate its prognostic value in RA patients and its potential associations with clinical features.
  
  
  METHODS
  The history of CV events was retrospectively reviewed in 160 RA patients and RDW was recorded at disease onset and 6 and 12 months after diagnosis to calculate the accumulated value [area under the curve (AUC) RDW] and change during the first year (ΔRDW). In addition, RDW was analysed in 110 patients with established disease in relation to clinical features.
  
  
  RESULTS
  Increased RDW at diagnosis and AUC RDW were able to predict the occurrence of CV events in RA patients [hazard ratio (HR) 1.247 (95% CI 1.079, 1.441), P = 0.003 and HR 1.038 (95% CI 1.018, 1.059), P = 0.0001, respectively] after adjusting by potential confounding factors. Receiver operating characteristic curve analyses revealed a better power of discrimination for the AUC RDW (P = 3.394 × 10(-5)). In addition, an increase in RDW during the first year was associated with poor CV outcome (P = 0.010). On the other hand, RDW in patients with established RA was significantly associated with disease activity, acute phase reactants and severity.
  
  
  CONCLUSIONS
  RDW at disease onset may be used as an early marker of CV risk in RA, whereas in patients with established disease it was related to the activity of the disease. These findings suggest that RDW can be considered as a surrogate marker of inflammation and, consequently, CV risk in RA patients.
authors.affiliation: Area of Immunology, Department of Functional Biology, University of Oviedo and Department of Rheumatology, Hospital Universitario Central de Asturias, Oveido, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Rodríguez-Carrio
authors.affiliation: Area of Immunology, Department of Functional Biology, University of Oviedo and Department of Rheumatology, Hospital Universitario Central de Asturias, Oveido, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Alperi-López
authors.affiliation: Area of Immunology, Department of Functional Biology, University of Oviedo and Department of Rheumatology, Hospital Universitario Central de Asturias, Oveido, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: López
authors.affiliation: Area of Immunology, Department of Functional Biology, University of Oviedo and Department of Rheumatology, Hospital Universitario Central de Asturias, Oveido, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Alonso-Castro
authors.affiliation: Area of Immunology, Department of Functional Biology, University of Oviedo and Department of Rheumatology, Hospital Universitario Central de Asturias, Oveido, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Ballina-García
authors.affiliation: Area of Immunology, Department of Functional Biology, University of Oviedo and Department of Rheumatology, Hospital Universitario Central de Asturias, Oveido, Spain. anasua@uniovi.es.
authors.forename: Ana
authors.initials: A
authors.lastname: Suárez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology; D004909:Erythrocyte Indices; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000453:epidemiology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000453:epidemiology; D055815:Young Adult
keywords: biomarker; cardiovascular disease; red cell distribution width; rheumatoid arthritis