Red blood cell distribution width predicts long-term outcome regardless of anaemia status in acute heart failure patients
Red blood cell distribution width predicts long-term outcome regardless of anaemia status in acute heart failure patients
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DOI：
10.1093/eurjhf/hfp109
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发表时间：
2009-09-01
影响因子：
18.2
通讯作者：
Valdes, Mariano
中科院分区：
文献类型：
--
作者：
Pascual-Figal, Domingo A.;Bonaque, Juan C.;Valdes, Mariano
目的 研究红细胞分布宽度 (RDW) 对因急性心力衰竭 (AHF) 住院的患者的长期预后价值，并将该测量值与血红蛋白水平和贫血状态进行比较。 在 2 年期间，我们连续研究了 628 名因 AHF 住院的患者（年龄 71 岁 [四分位距，IQR：61-77]，68% 为男性）。出院时登记人口统计学、临床、超声心动图和实验室特征，并对患者进行为期 38.1 个月的密切随访 [16.5-49.1]。 RDW 中位数为 14.4% [13.5-15.5]，死者中较高（15.0% [13.8-16.1] vs. 14.2 [13.3-15.3]，P < 0.001）。在多变量 Cox 比例风险模型中调整其他预后因素后，RDW 仍然是一个显着的预测因子（P = 0.004，HR 1.072，95% CI 1.023-1.124）；然而，血红蛋白或贫血状态并没有增加预后信息。高于中位数的 RDW 水平与长期随访中显着较低的生存率相关（对数秩 < 0.001）。即使在多变量模型中进行调整后，这些水平也可预测贫血患者 (n = 263，P = 0.029)，特别是非贫血患者 (n = 365)（P < 0.001，HR 1.287，95% CI 1.147-1.445）。出院时较高的 RDW 水平与较差的长期结局相关，无论血红蛋白水平和贫血状态。
To study the long-term prognostic value of red blood cell distribution width (RDW) in patients hospitalized with acute heart failure (AHF) and to compare the value of this measurement with haemoglobin levels and anaemia status.During a 2-year period, we studied 628 consecutive patients (aged 71 years [interquartile range, IQR: 61-77], 68% male) hospitalized with AHF. Demographic, clinical, echocardiographic, and laboratory characteristics were registered at discharge and patients were closely followed-up for 38.1 months [16.5-49.1]. Median RDW was 14.4% [13.5-15.5] and was higher among decedents (15.0% [13.8-16.1] vs. 14.2 [13.3-15.3], P < 0.001). After adjustment for other prognostic factors in a multivariable Cox proportional-hazards model, RDW remained a significant predictor (P = 0.004, HR 1.072, 95% CI 1.023-1.124); whereas, haemoglobin or anaemia status did not add prognostic information. RDW levels above the median were associated with a significantly lower survival rate on long-term follow-up (log rank < 0.001). These levels were predictive of death in anaemic patients (n = 263, P = 0.029) and especially in non-anaemic patients (n = 365) (P < 0.001, HR 1.287, 95% CI 1.147-1.445), even after adjustment in the multivariable model.Higher RDW levels at discharge were associated with a worse long-term outcome, regardless of haemoglobin levels and anaemia status.