Red cell distribution width in adults with congenital heart disease: A worldwide available and low-cost predictor of cardiovascular events
Red cell distribution width in adults with congenital heart disease: A worldwide available and low-cost predictor of cardiovascular events
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DOI：
10.1016/j.ijcard.2018.02.118
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发表时间：
2018-06-01
影响因子：
3.5
通讯作者：
Roos-Hesselink, Jolien W.
中科院分区：
文献类型：
--
作者：
Baggen, Vivan J. M.;van den Bosch, Annemien E.;Roos-Hesselink, Jolien W.
背景：红细胞分布宽度（RDW）是自动血细胞计数的标准组成部分，在心力衰竭和冠心病中具有预后价值。我们研究了RDW与成人先天性心脏病（ACHD）患者心血管事件之间的关系。方法与结果：在这项前瞻性队列研究中，纳入了2011 - 2013年间602例常规门诊就诊的连续ACHD患者。在纳入592例患者（中位年龄33岁[IQR 25-41]岁，58%男性，90% NYHA I）和每年4次随访时，在新鲜静脉血样本中测量RDW。在4.3年[IQR 3.8-4.7]年的随访中，196例（33%）患者出现主要终点（死亡、心力衰竭、住院、心律失常、血栓栓塞事件、心脏干预）。在有无主要终点的患者中，中位RDW分别为13.4(12.8-14.1)%和12.9 (12.5-13.4)% （P < 0.001）。经年龄、性别、临床危险因素、CRP和NT-proBNP校正后，RDW与终点显著相关（HR 1.20; 95% CI 1.06-1.35； P=0.003）。包含RDW的模型的c指数略高于未包含RDW的模型（0.74,95% CI 0.70-0.78 vs 0.73, 95% CI 0.69-0.78），但显著（P=0.005）。重复RDWmeasurements的分析（n=2449）未显示在终点发生之前RDW增加。结论：RDW与ACHD患者的心血管事件相关，独立于年龄、性别、临床危险因素、CRP和NT-proBNP。因此，这种容易获得的生物标志物可以被认为是这些患者风险分层的附加生物标志物。(c) 2018年作者。Elsevier B.V.出版
Background: Red cell distribution width (RDW) is a standard component of the automated blood count, and is of prognostic value in heart failure and coronary heart disease. We investigated the association between RDW and cardiovascular events in patients with adult congenital heart disease (ACHD).Methods and results: In this prospective cohort study, 602 consecutive patients with ACHD who routinely visited the outpatient clinic were enrolled between 2011 and 2013. RDW was measured in fresh venous blood samples at inclusion in 592 patients (median age 33 [IQR 25-41] years, 58% male, 90% NYHA I) and at four annual follow-up visits. During 4.3 [IQR 3.8-4.7] years of follow-up, the primary endpoint (death, heart failure, hospitalization, arrhythmia, thromboembolic events, cardiac intervention) occurred in 196 patients (33%). Median RDW was 13.4 (12.8-14.1)% versus 12.9 (12.5-13.4)% in patients with and without the primary endpoint (P < 0.001). RDW was significantly associated with the endpoint when adjusted for age, sex, clinical risk factors, CRP, and NT-proBNP (HR 1.20; 95% CI 1.06-1.35; P=0.003). The C-index of the model including RDW was slightly, but significantly (P=0.005) higher than the model without (0.74, 95% CI 0.70-0.78 versus 0.73, 95% CI 0.69-0.78). Analysis of repeated RDWmeasurements (n=2449) did not show an increase in RDW prior to the occurrence of the endpoint.Conclusions: RDW is associated with cardiovascular events in patients with ACHD, independently of age, sex, clinical risk factors, CRP, and NT-proBNP. This readily available biomarker could therefore be considered as an additive biomarker for risk stratification in these patients. (c) 2018 The Authors. Published by Elsevier B.V.