Expansion of the red cell distribution width and evolving iron deficiency as predictors of poor outcome in chronic heart failure
Expansion of the red cell distribution width and evolving iron deficiency as predictors of poor outcome in chronic heart failure
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DOI：
10.1016/j.ijcard.2012.12.091
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发表时间：
2013-10-03
影响因子：
3.5
通讯作者：
Okonko, Darlington O.
中科院分区：
文献类型：
--
作者：
Aung, Nay;Ling, Hua Zen;Okonko, Darlington O.
背景。基线时红细胞分布宽度（RDW）升高和铁缺乏（ID）预测慢性心力衰竭（CHF）死亡率增加，但对其时间趋势的预后意义知之甚少。我们试图确定chf患者的RDW和ID的时间变化对生存的影响。分析274例稳定期收缩期CHF患者首次会诊时红细胞指标及随时间推移与死亡率的关系。随着时间的推移，RDW上升和平均细胞体积（MCV）下降的组合定义了不断变化的id。在中位12个月期间，分别有51%和23%的患者RDW和演进性ID上升。中位随访27个月后，60例（22%）患者死亡。RDW升高预测全因死亡率升高(未经调整的HR为1%，每周升高9.27,95% CI为3.58至24.00,P0.02%，每周最佳预测。进化的ID也与较高的死亡率相关(HR 2.78, 95% CI 1.64 ~ 4.73， P
Background. An elevated red cell distribution width (RDW) and iron deficiency (ID) at baseline predict enhanced mortality in chronic heart failure (CHF), but little is known about the prognostic implications of their temporal trends. We sought to determine the survival implications of temporal changes in RDW and evolving ID in patients with CHF.Methods. The relation between red cell indices on first consultation and over time with mortality in 274 stable patients with systolic CHF was analysed. The combination of a rising RDW with a falling mean cell volume (MCV) over time defined evolving ID.Results. Over amedian 12 month period, 51% and 23% of patients had a rise in RDW and evolving ID, respectively. After a median follow-up of 27 months, 60 (22%) patients died. A rising RDW predicted enhanced all-cause mortality (unadjusted HR for 1% per week rise 9.27, 95% CI 3.58 to 24.00, P0.02% per week optimally predictive. Evolving ID also related to higher rates of mortality (HR 2.78, 95% CI 1.64 to 4.73, P