Red Blood Cell Distribution Width Is a Predictive Factor of Anthracycline-Induced Cardiotoxicity.
Red Blood Cell Distribution Width Is a Predictive Factor of Anthracycline-Induced Cardiotoxicity.
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DOI：
10.3389/fcvm.2020.594685
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发表时间：
2020
影响因子：
3.6
通讯作者：
Takeishi Y
中科院分区：
文献类型：
--
作者：
Yaegashi D;Oikawa M;Yokokawa T;Misaka T;Kobayashi A;Kaneshiro T;Yoshihisa A;Nakazato K;Ishida T;Takeishi Y
背景资料：红细胞分布宽度（RDW）与心血管疾病的预后密切相关，但与癌症治疗相关性心功能不全（CTRCD）的关系尚不清楚。目的：本研究的目的是评估RDW是否可以预测蒽环类药物所致的CTRCD的发生。方法：对202例接受蒽环类药物治疗的恶性肿瘤患者进行为期12个月的随访。根据化疗前基线RDW的中位数将患者分为2组[低RDW组，n = 98，13.0 [12.6-13.2];高RDW组，n = 104，14.9 [13.9-17.0]]。在基线（化疗前）以及蒽环类药物化疗后3、6和12个月，通过超声心动图连续评估心脏功能。结果：两组基线左室收缩末期容积指数和射血分数（EF）相似。化疗后，高RDW组的EF在3个月和6个月时下降[基线，64.5% [61.9-68.9%]; 3个月，62.6% [60.4-66.9%]; 6个月，63.9% [60.0-67.9%]; 12个月，64.7% [60.8-67.0%]，P = 0.04]，但在低RDW组中未观察到变化。高RDW组CTRCD发生率高于低RDW组（11.5vs.2.0%，P = 0.008）。当我们设定RDW的截止值为13.8时，预测CTRCD的敏感性和特异性分别为84.6%和62.0%。多因素Logistic回归分析显示，基线RDW值是发生CTRCD的独立预测因子[比值比1.390，95%CI [1.09-1.78]，P = 0.008]。将基线RDW值加入包括蒽环类药物累积剂量、EF、白蛋白和高血压等已知危险因素的回归模型中，净再分类指数（NRI）和综合辨别力改善（IDI）对CTRCD的检测价值达到统计学显著性水平; NRI为0.9252（95%CI 0.4103-1.4402，P < 0.001），IDI为0.1125（95%CI 0.0078-0.2171，P = 0.035）。结论：基线RDW是预测蒽环类药物诱导的CTRCD的新参数。
Background: Red blood cell distribution width (RDW) is associated with prognosis in widespread cardiovascular fields, but little is known about relationship with the onset of cancer therapeutics-related cardiac dysfunction (CTRCD). Objectives: The purpose of this study was to assess whether RDW could predict the onset of CTRCD by anthracycline. Methods: Consequential 202 cancer patients planed for anthracycline treatment were enrolled and followed up for 12 months. The patients were divided into 2 groups based on the median value of baseline RDW before chemotherapy [low RDW group, n = 98, 13.0 [12.6–13.2]; high RDW group, n = 104, 14.9 [13.9–17.0]]. Cardiac function was assessed serially by echocardiography at baseline (before chemotherapy), as well as at 3, 6, and 12 months after chemotherapy with anthracycline. Results: Baseline left ventricular end systolic volume index and ejection fraction (EF) were similar between two groups. After chemotherapy, EF decreased at 3- and 6-month in the high RDW group [baseline, 64.5% [61.9–68.9%]; 3-month, 62.6% [60.4–66.9%]; 6-month, 63.9% [60.0–67.9%]; 12-month, 64.7% [60.8–67.0%], P = 0.04], but no change was observed in low RDW group. The occurrence of CTRCD was higher in high RDW group than in low RDW group (11.5 vs. 2.0%, P = 0.008). When we set the cut-off value of RDW at 13.8, sensitivity and specificity to predict CTRCD were 84.6 and 62.0%, respectively. Multivariable logistic regression analysis revealed that baseline RDW value was an independent predictor of the development of CTRCD [odds ratio 1.390, 95% CI [1.09–1.78], P = 0.008]. The value of net reclassification index (NRI) and integrated discrimination improvement (IDI) for detecting CTRCD reached statistical significance when baseline RDW value was added to the regression model including known risk factors such as cumulative anthracycline dose, EF, albumin, and the presence of hypertension; 0.9252 (95%CI 0.4103–1.4402, P < 0.001) for NRI and 0.1125 (95%CI 0.0078–0.2171, P = 0.035) for IDI. Conclusions: Baseline RDW is a novel parameter to predict anthracycline-induced CTRCD.
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影响因子：
1.7
作者：
Berliner, Dominik;Beutel, Gernot;Bauersachs, Johann
通讯作者：
Bauersachs, Johann
影响因子：
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作者：
Podhorecka M;Halicka D;Szymczyk A;Macheta A;Chocholska S;Hus M;Darzynkiewicz Z
通讯作者：
Darzynkiewicz Z
影响因子：
6.2
作者：
Lang, Roberto M.;Badano, Luigi P.;Voigt, Jens-Uwe
通讯作者：
Voigt, Jens-Uwe
影响因子：
1.9
作者：
Abrahan LL 4th;Ramos JDA;Cunanan EL;Tiongson MDA;Punzalan FER
通讯作者：
Punzalan FER
影响因子：
6.8
作者：
Kemal, Yasemin;Demirag, Guzin;Yucel, Idris
通讯作者：
Yucel, Idris