title: Red cell distribution width as a novel predictor for clinical outcomes in patients with paroxysmal atrial fibrillation.
abstract: OBJECTIVE
  Elevated red cell distribution width (RDW) has been known to be associated with adverse long-term outcomes in patients with cardiovascular diseases. We aimed to evaluate relationship between RDW values and clinical outcomes in patients with paroxysmal atrial fibrillation (AF).
  
  
  RESULTS
  We analysed 567 patients who were newly diagnosed as paroxysmal AF. Clinical outcomes were analysed after median 4.8 (3.4-6.9) years follow-up. The composite clinical outcomes were defined as the composite of death, hospitalization due to heart failure, and new-onset stroke. Bleeding events were composed of major and minor bleeding. The relationship of RDW with clinical outcomes was assessed using continuous or categorical variables as quartiles: <12.8, 12.8-13.2, 13.3-13.8, and ≥13.9%. Patients with the highest RDW quartile were the oldest and had more frequent history of heart failure. CHA2DS2-VASc score was increased along with increasing RDW quartiles (1.75 ± 1.48 vs. 1.77 ± 1.63 vs. 1.87 ± 1.61 vs. 2.33 ± 1.65, P = 0.008). Incidence of new-onset stroke (log-rank P = 0.032), the composite clinical outcomes (log-rank P = 0.014), and bleeding events (log-rank P = 0.001) were increased as increasing RDW quartiles. Multivariate analysis identified that RDW was a significant predictor for new-onset stroke [adjusted hazard ratio (HR) 1.32, 95% confidence interval (CI) 1.06-1.65, P = 0.015], the composite clinical outcomes (adjusted HR 1.21, 95% CI 1.03-1.41, P = 0.017), and bleeding events (adjusted HR 1.36, 95% CI 1.13-1.64, P = 0.001).
  
  
  CONCLUSIONS
  RDW can be a new, useful, novel predictor of clinical and safety outcomes in patients with paroxysmal AF.
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Ki Hong
authors: KH
authors: Lee
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea mdhwp@chol.com.
authors: Hyung Wook
authors: HW
authors: Park
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Jeong Gwan
authors: JG
authors: Cho
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Nam Sik
authors: NS
authors: Yoon
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Sung Soo
authors: SS
authors: Kim
authors: Chunnam Techno University, Chonnam, South Korea.
authors: Mi Ran
authors: MR
authors: Kim
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Min Chul
authors: MC
authors: Kim
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Kyung Hoon
authors: KH
authors: Cho
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Hyun Kuk
authors: HK
authors: Kim
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Cheol Hwan
authors: CH
authors: Kim
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Kyung Hwan
authors: KH
authors: Kim
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Seung Jin
authors: SJ
authors: Jun
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Woo Jin
authors: WJ
authors: Kim
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Kyoung Jin
authors: KJ
authors: Lee
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Hae Chang
authors: HC
authors: Jeong
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Jae Yeong
authors: JY
authors: Cho
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Keun-Ho
authors: KH
authors: Park
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Doo sun
authors: Ds
authors: Sim
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Hyun Ju
authors: HJ
authors: Yoon
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Kye Hun
authors: KH
authors: Kim
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Young Joon
authors: YJ
authors: Hong
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Ju Han
authors: JH
authors: Kim
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Youngkeun
authors: Y
authors: Ahn
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Myung Ho
authors: MH
authors: Jeong
authors: The Heart Center of Chonnam National University Hospital, 42 Jaebongro, Dong-gu, Gwangju 501-757, South Korea.
authors: Jong Chun
authors: JC
authors: Park
mesh_terms: D001281:Atrial Fibrillation / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D004909:Erythrocyte Indices; D004912:Erythrocytes / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D015203:Reproducibility of Results; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016019:Survival Analysis
keywords: Atrial fibrillation; Prognosis; Red cell distribution width; Safety