Validation and potential mechanisms of red cell distribution width as a prognostic marker in heart failure.
Validation and potential mechanisms of red cell distribution width as a prognostic marker in heart failure.
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DOI：
10.1016/j.cardfail.2009.11.003
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发表时间：
2010-03
影响因子：
6
通讯作者：
Adams, Kirkwood F., Jr.
中科院分区：
文献类型：
--
作者：
Allen, Larry A.;Felker, G. Michael;Mehra, Mandeep R.;Chiong, Jun R.;Dunlap, Stephanie H.;Ghali, Jalal K.;Lenihan, Daniel J.;Oren, Ron M.;Wagoner, Lynne E.;Schwartz, Todd A.;Adams, Kirkwood F., Jr.
最近，不良后果与心力衰竭患者红细胞分布宽度(RDW)升高有关。我们的研究试图验证RDW在心力衰竭中的预后价值，并探索这种关联的潜在机制。来自心力衰竭人群贫血研究(STATINA-HFP)登记的数据支持多变量建模，以评估RDW和预后之间的关系。这是一项针对心力衰竭患者的前瞻性多中心队列研究。RDW与铁代谢、炎症和神经激素激活之间的关系在来自联合调查员评估心力衰竭(Unite-HF)生物标记物注册的单独心力衰竭患者队列中进行了研究。RDW独立预测预后(RDW每增加1%，死亡风险比1.06，95%可信区间1.01~1.12；住院或死亡风险比1.06；95%可信区间1.02~1.10)。RDW的增加与血红蛋白降低、白细胞介素6升高和铁动员受损相关。我们的结果证实了先前的观察，即RDW是慢性心力衰竭不良结局的一个强有力的独立预测因子，并提示RDW升高可能表明炎症应激和铁动员受损。这些发现鼓励进一步研究心力衰竭和血液系统之间的关系。
Adverse outcomes have recently been linked to elevated red cell distribution width (RDW) in heart failure. Our study sought to validate the prognostic value of RDW in heart failure and to explore the potential mechanisms underlying this association. Data from the Study of Anemia in a Heart Failure Population (STAMINA-HFP) registry, a prospective, multicenter cohort of ambulatory patients with heart failure supported multivariable modeling to assess relationships between RDW and outcomes. The association between RDW and iron metabolism, inflammation, and neurohormonal activation was studied in a separate cohort of heart failure patients from the United Investigators to Evaluate Heart Failure (UNITE-HF) Biomarker registry. RDW was independently predictive of outcome (for each 1% increase in RDW, hazard ratio for mortality 1.06, 95% CI 1.01-1.12; hazard ratio for hospitalization or mortality 1.06; 95% CI 1.02-1.10) after adjustment for other covariates. Increasing RDW correlated with decreasing hemoglobin, increasing interleukin-6, and impaired iron mobilization. Our results confirm previous observations that RDW is a strong, independent predictor of adverse outcome in chronic heart failure and suggest elevated RDW may indicate inflammatory stress and impaired iron mobilization. These findings encourage further research into the relationship between heart failure and the hematologic system.
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影响因子：
--
作者：
Patel, Kushang V.;Ferrucci, Luigi;Ershler, William B.;Longo, Dan L.;Guralnik, Jack M.
通讯作者：
Guralnik, Jack M.
DOI：
10.1016/s0735-1097(03)00425-x
发表时间：
2003-06-04
影响因子：
24
作者：
Mozaffarian, D;Nye, R;Levy, WC
通讯作者：
Levy, WC
影响因子：
4.8
作者：
Adams, Kirkwood F., Jr.;Patterson, John H.;Ghali, Jalal K.
通讯作者：
Ghali, Jalal K.
影响因子：
--
作者：
Perlstein, Todd S.;Weuve, Jennifer;Pfeffer, Marc A.;Beckman, Joshua A.
通讯作者：
Beckman, Joshua A.
影响因子：
15.9
作者：
Nicolas, G;Chauvet, C;Vaulont, S
通讯作者：
Vaulont, S