title: Red blood cell distribution width is a survival predictor beyond anemia and Nt-ProBNP in stable optimally medicated heart failure with reduced ejection fraction outpatients.
abstract: BACKGROUND
  RDW is an automatic value obtained with the blood count, and represents the erythrocytes dimension variation.
  
  
  OBJECTIVE
  To evaluate in optimally medicated outpatients with heart failure with reduced ejection fraction (HFrEF) the RDW prognostic value regarding survival in a multivariable model including anemia and Nt-ProBNP.
  
  
  METHODS
  233 consecutive outpatients, LVEF <40%, clinically stable were followed-up for 3-years in an HF Unit. End-point was all-cause death. The RDW categorized according to the tertiles (T1 = <13.9; T2 14-15.2; T3> = 15.3). Anemia classified according to the WHO criteria. Cox survival model adjusted for clinical profile, optimal therapeutic, renal function, Nt-ProBNP, etiology, atrial fibrillation, and anemia.
  
  
  RESULTS
  (1) The 3-years death rate was 33.5%, and increased with the RDW tertiles (17.3%; 25%; 61.1%; p < 0.001). (2) The ROC curve for death associated with RDW (AUC 0.73; p < 0.001); (3) The adjusted death risk increased with the tertiles (Hazard-ratio '[HR] = 1.61; IC 95% 1.09-2.39; p = 0.017). RDW> = 15.3 had greater adjusted death risk than T1 (HR = 2.18; 95% CI 0.99-4.8; p = 0.05) and T1+T2 (HR = 1.54; 95% CI 1.13-2.09; p = 0.006).
  
  
  CONCLUSIONS
  RDW determined in optimally medicated outpatients with HFrEF, during dry-state, is a strong, cheap, and independent predictor of long-term survival.
authors.forename: Luis
authors.initials: L
authors.lastname: Sargento
authors.forename: Andre Vicente
authors.initials: AV
authors.lastname: Simões
authors.forename: Susana
authors.initials: S
authors.lastname: Longo
authors.forename: Nuno
authors.initials: N
authors.lastname: Lousada
authors.forename: Roberto
authors.initials: R
authors.lastname: Palma Dos Reis
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood*; D004909:Erythrocyte Indices; D005260:Female; D006333:Heart Failure / Q000097:blood*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D013318:Stroke Volume / Q000502:physiology*
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Nt-ProBNP; Rdw; anemia; systolic heart failure