Red blood cell distribution width and 1-year mortality in acute heart failure
Red blood cell distribution width and 1-year mortality in acute heart failure
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DOI：
10.1093/eurjhf/hfp179
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发表时间：
2010-02-01
影响因子：
18.2
通讯作者：
Januzzi, James L., Jr.
中科院分区：
文献类型：
--
作者：
van Kimmenade, Roland R. J.;Mohammed, Asim A.;Januzzi, James L., Jr.
红细胞分布宽度（RDW）可预测慢性心力衰竭（HF）和稳定性冠状动脉疾病的死亡率。RDW在更急性的环境中的预后价值，如急性HF，其相对预后价值相比，更成熟的措施，如N-末端脑利钠肽前体（NT-proBNP），仍然是未知的。在一个队列的205例急性HF患者中，独立的预测RDW被确定使用线性回归分析。采用考克斯比例风险分析评估RDW和1年生存率在其他预测因素背景下的相关性。67例（32.7%）患者的红细胞分布宽度升高; RDW与血液学变量（如血红蛋白（P < 0.001））以及在就诊时使用袢利尿剂（P = 0.006）和β受体阻滞剂（P = 0.015）独立相关，但与营养缺乏、近期输血或炎症变量无关。多变量考克斯比例风险分析中对数转换RDW值独立预测死亡率（风险比，1.03; 95%置信区间，1.00-1.06; P = 0.04）;当基于RDW和NT-proBNP状态分层时，联合用药提供了额外的预后信息。急性心衰患者红细胞分布宽度经常升高，与营养状况、输血史或炎症有关。红细胞分布宽度可独立预测急性HF患者的1年死亡率。RDW的值似乎与其他已确定的预后变量（如NT-proBNP）相加。
Red blood cell distribution width (RDW) predicts mortality in chronic heart failure (HF) and stable coronary artery disease. The prognostic value of RDW in more acute settings such as acute HF, and its relative prognostic value compared with more established measures such as N-terminal pro-brain natriuretic peptide (NT-proBNP), remains unknown.In a cohort of 205 patients with acute HF, independent predictors of RDW were identified using linear regression analysis. The association between RDW and 1-year survival in the context of other predictors was assessed using Cox's proportional hazards analysis. Red blood cell distribution width was elevated in 67 (32.7%) patients; RDW was independently associated with haematological variables such as haemoglobin (P < 0.001) as well as the use of loop diuretics (P = 0.006) and beta-blockers (P = 0.015) on presentation, but not with nutritional deficiencies, recent transfusion, or inflammatory variables. Log-transformed RDW values independently predicted mortality in multivariable Cox's proportional hazards analysis (hazards ratio, 1.03; 95% confidence interval, 1.00-1.06; P = 0.04); when stratified on the basis of RDW and NT-proBNP status, the combination provided additional prognostic information.Red blood cell distribution width is frequently elevated among patients with acute HF and does not appear to be associated with nutritional status, transfusion history, or inflammation. Red blood cell distribution width independently predicts 1-year mortality in acute HF. The value of RDW appears additive to other established prognostic variables such as NT-proBNP.