title: Red cell distribution width in anemic patients undergoing transcatheter aortic valve implantation.
abstract: OBJECTIVE
  To determine the impact of red blood cell distribution width on outcome in anemic patients undergoing transcatheter aortic valve implantation (TAVI).
  
  
  METHODS
  In a retrospective single center cohort study we determined the impact of baseline red cell distribution width (RDW) and anemia on outcome in 376 patients with aortic stenosis undergoing TAVI. All patients were discussed in the institutional heart team and declined for surgical aortic valve replacement due to high operative risk. Collected data included patient characteristics, imaging findings, periprocedural in hospital data, laboratory results and follow up data. Blood samples for hematology and biochemistry analysis were taken from every patient before and at fixed intervals up to 72 h after TAVI including blood count and creatinine. Descriptive statistics were used for patient's characteristics. Kaplan-Meier survival curves were used for time to event outcomes. A recursive partitioning regression and classification was used to investigate the association between potential risk factors and outcome variables.
  
  
  RESULTS
  Mean age in our study population was 81 ± 6.1 years. Anemia was prevalent in 63.6% (n = 239) of our patients. Age and creatinine were identified as risk factors for anemia. In our study population, anemia per se did influence 30-d mortality but did not predict longterm mortality. In contrast, a RDW > 14% showed to be highly predictable for a reduced short- and longterm survival in patients with aortic valve disease after TAVI procedure.
  
  
  CONCLUSIONS
  Age and kidney function determine the degree of anemia. The anisocytosis of red blood cells in anemic patients supplements prognostic information in addition to that derived from the WHO-based definition of anemia.
authors.affiliation: Katharina Hellhammer, Tobias Zeus, Verena Veulemanns, Lisa Kahlstadt, Georg Wolff, Ralf Erkens, Ralf Westenfeld, Eliano P Navarese, Marc W Merx, Tienush Rassaf, Malte Kelm, Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Düsseldorf, 40225 Düsseldorf, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Hellhammer
authors.affiliation: Katharina Hellhammer, Tobias Zeus, Verena Veulemanns, Lisa Kahlstadt, Georg Wolff, Ralf Erkens, Ralf Westenfeld, Eliano P Navarese, Marc W Merx, Tienush Rassaf, Malte Kelm, Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Düsseldorf, 40225 Düsseldorf, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Zeus
authors.affiliation: Katharina Hellhammer, Tobias Zeus, Verena Veulemanns, Lisa Kahlstadt, Georg Wolff, Ralf Erkens, Ralf Westenfeld, Eliano P Navarese, Marc W Merx, Tienush Rassaf, Malte Kelm, Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Düsseldorf, 40225 Düsseldorf, Germany.
authors.forename: Pablo E
authors.initials: PE
authors.lastname: Verde
authors.affiliation: Katharina Hellhammer, Tobias Zeus, Verena Veulemanns, Lisa Kahlstadt, Georg Wolff, Ralf Erkens, Ralf Westenfeld, Eliano P Navarese, Marc W Merx, Tienush Rassaf, Malte Kelm, Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Düsseldorf, 40225 Düsseldorf, Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: Veulemanns
authors.affiliation: Katharina Hellhammer, Tobias Zeus, Verena Veulemanns, Lisa Kahlstadt, Georg Wolff, Ralf Erkens, Ralf Westenfeld, Eliano P Navarese, Marc W Merx, Tienush Rassaf, Malte Kelm, Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Düsseldorf, 40225 Düsseldorf, Germany.
authors.forename: Lisa
authors.initials: L
authors.lastname: Kahlstadt
authors.affiliation: Katharina Hellhammer, Tobias Zeus, Verena Veulemanns, Lisa Kahlstadt, Georg Wolff, Ralf Erkens, Ralf Westenfeld, Eliano P Navarese, Marc W Merx, Tienush Rassaf, Malte Kelm, Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Düsseldorf, 40225 Düsseldorf, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Wolff
authors.affiliation: Katharina Hellhammer, Tobias Zeus, Verena Veulemanns, Lisa Kahlstadt, Georg Wolff, Ralf Erkens, Ralf Westenfeld, Eliano P Navarese, Marc W Merx, Tienush Rassaf, Malte Kelm, Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Düsseldorf, 40225 Düsseldorf, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Erkens
authors.affiliation: Katharina Hellhammer, Tobias Zeus, Verena Veulemanns, Lisa Kahlstadt, Georg Wolff, Ralf Erkens, Ralf Westenfeld, Eliano P Navarese, Marc W Merx, Tienush Rassaf, Malte Kelm, Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Düsseldorf, 40225 Düsseldorf, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Westenfeld
authors.affiliation: Katharina Hellhammer, Tobias Zeus, Verena Veulemanns, Lisa Kahlstadt, Georg Wolff, Ralf Erkens, Ralf Westenfeld, Eliano P Navarese, Marc W Merx, Tienush Rassaf, Malte Kelm, Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Düsseldorf, 40225 Düsseldorf, Germany.
authors.forename: Eliano P
authors.initials: EP
authors.lastname: Navarese
authors.affiliation: Katharina Hellhammer, Tobias Zeus, Verena Veulemanns, Lisa Kahlstadt, Georg Wolff, Ralf Erkens, Ralf Westenfeld, Eliano P Navarese, Marc W Merx, Tienush Rassaf, Malte Kelm, Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Düsseldorf, 40225 Düsseldorf, Germany.
authors.forename: Marc W
authors.initials: MW
authors.lastname: Merx
authors.affiliation: Katharina Hellhammer, Tobias Zeus, Verena Veulemanns, Lisa Kahlstadt, Georg Wolff, Ralf Erkens, Ralf Westenfeld, Eliano P Navarese, Marc W Merx, Tienush Rassaf, Malte Kelm, Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Düsseldorf, 40225 Düsseldorf, Germany.
authors.forename: Tienush
authors.initials: T
authors.lastname: Rassaf
authors.affiliation: Katharina Hellhammer, Tobias Zeus, Verena Veulemanns, Lisa Kahlstadt, Georg Wolff, Ralf Erkens, Ralf Westenfeld, Eliano P Navarese, Marc W Merx, Tienush Rassaf, Malte Kelm, Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Düsseldorf, 40225 Düsseldorf, Germany.
authors.forename: Malte
authors.initials: M
authors.lastname: Kelm
keywords: Anemia; Aortic stenosis; Red blood cells; Red cell distribution width; Transcatheter aortic valve implantation