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Heshmat-Ghahdarijani K, Fakhrolmobasheri M. Is Red Cell Distribution Width a Reliable Marker for Cardiovascular Diseases? A Narrative Review. Cardiol Rev 2024; 32:362-370. [PMID: 36730493 DOI: 10.1097/crd.0000000000000500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Red cell distribution width (RDW) is an easy-to-access marker which is routinely measured in complete blood count (CBC) test. Besides the classic use of RDW as a marker for discriminating different types of anemia, recent studies had indicated the relationship between high RDW and cardiovascular diseases. High RDW is not only useful in the diagnosis and prognostication of various cardiovascular conditions but also could be used as a valuable tool for predicting the incidence of cardiovascular diseases. population-based studies have indicated that higher RDW could effectively predict the incidence of heart failure (HF), atherosclerotic diseases, and atrial fibrillation (AF). It has been also demonstrated that higher RDW is associated with worse outcomes in these diseases. Recent studies have shown that high RDW is also associated with other cardiovascular conditions including cardiomyopathies, and pulmonary hypertension. The predictive role of RDW in endovascular interventions has also been demonstrated by many recent studies. Here in this review, we attempt to compile the most recent findings with older reports regarding the relation between high RDW and HF, cardiomyopathies, pulmonary hypertension, AF, atherosclerotic disorders, primary hypertension, and the outcomes of endovascular interventions. we also discussed the role of RDW in the prognostication of different cardiovascular conditions when combined with classic classification criteria.
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Affiliation(s)
- Kiyan Heshmat-Ghahdarijani
- From the Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Fakhrolmobasheri
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Soh RYH, Sia CH, Djohan AH, Lau RH, Ho PY, Neo JWH, Ho JSY, Sim HW, Yeo TC, Tan HC, Chan MYY, Loh JPY. Clinical Characteristics and Long-Term Outcomes of Patients With Differing Haemoglobin Levels Undergoing Semi-Urgent and Elective Percutaneous Coronary Intervention in an Asian Population. Front Cardiovasc Med 2022; 9:687555. [PMID: 35369342 PMCID: PMC8971291 DOI: 10.3389/fcvm.2022.687555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction This study aimed to investigate the impact of anaemia on long-term clinical outcomes in patients who underwent semi-urgent and elective percutaneous coronary intervention (PCI) in an Asian population. Although the effects of anaemia on outcomes in Asian patients are well studied for acute coronary syndrome, its impact on Asian patients undergoing semi-urgent and elective PCI is unclear. Methods This was a retrospective cohort study of patients who underwent semi-urgent and elective PCI from January 1, 2014, to December 31, 2015, at a tertiary academic centre. A total of 1,685 patients were included. They were stratified into three groups: normal (≥12 g/dL), intermediate (10–11.9 g/dL), and low (<10 g/dL) haemoglobin levels. Demographics, risk factors, and end-points including the 5-point major adverse cardiac and cerebrovascular events (MACCE) (all-cause death, subsequent stroke, myocardial infarction, congestive cardiac failure, and target lesion revascularisation), cardiovascular death, and bleeding events were analysed. Results Patients in intermediate and low haemoglobin level groups were older with more comorbidities. Compared to the normal haemoglobin level group, low haemoglobin level group patients were associated with an increased risk of composite endpoints of all-cause death, subsequent stroke, myocardial infarction, congestive cardiac failure, and target lesion revascularisation [adjusted hazard ratio (aHR) 1.89, 95% confidence interval (CI):1.22, 2.92; p = 0.004]. This was driven by the increased risk of target lesions revascularisation observed in the low haemoglobin level group compared to the normal haemoglobin level group (aHR 17.74, 95% CI: 1.74, 180.80; p = 0.015). The patients in the low haemoglobin level group were also associated with a higher risk of bleeding events compared to the normal haemoglobin level group (aHR 7.18, 95% CI: 1.13, 45.40; p = 0.036). Conclusion In our Asian cohort, patients with anaemia undergoing PCI were associated with a higher comorbid burden. Despite adjustments for comorbidities, these patients had higher mortality and worse cardiovascular outcomes following contemporary PCI.
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Affiliation(s)
- Rodney Yu-Hang Soh
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
| | - Ching-Hui Sia
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, Singapore, Singapore
- *Correspondence: Ching-Hui Sia,
| | | | - Rui-Huai Lau
- Department of Medicine, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - Pei-Ying Ho
- Department of Medicine, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - Jonathan Wen-Hui Neo
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
| | - Jamie Sin-Ying Ho
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Hui-Wen Sim
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
| | - Tiong-Cheng Yeo
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - Huay-Cheem Tan
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
| | - Mark Yan-Yee Chan
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - Joshua Ping-Yun Loh
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, Singapore, Singapore
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Liao MT, Lai CL, Wang TC, Lin JW, Ho YL, Chan KA. Red Cell Distribution Width and Mortality in Patients Undergoing Percutaneous Coronary Intervention. Biomedicines 2021; 10:biomedicines10010045. [PMID: 35052725 PMCID: PMC8772904 DOI: 10.3390/biomedicines10010045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 12/23/2022] Open
Abstract
Red cell distribution width (RDW) can effectively predict prognosis in coronary artery disease (CAD) patients following percutaneous coronary intervention (PCI). There is currently no relevant research to demonstrate a linear or non-linear association between RDW and mortality. This is a multi-center, retrospective cohort study, with data collected from 2006 to 2017. Source data included electronic medical records of the Integrated Medical Database of National Taiwan University Hospital, and health insurance claims from the National Health Insurance Administration. Patients were stratified into five groups according to RDW values (13.4%, 14.1%, 14.8%, and 15.9%). Multivariable logistic and Cox regression analyses were used to determine 1-year all-cause and cardiovascular (CV) mortalities. Data of 10,669 patients were analyzed and those with the lowest RDW (≤13.3%) served as the reference group. The adjusted odds ratios (ORs) of 1-year all-cause mortality from the second to fifth RDW group were 1.386, 1.589, 2.090, and 3.192, respectively (p for trend < 0.001). The adjusted ORs of 1-year CV mortality were 1.555, 1.585, 1.623, and 2.850, respectively (p for trend = 0.015). The adjusted hazard ratios (HRs) of 1-year all-cause mortality were 1.394, 1.592, 2.003, and 2.689, respectively (p for trend = 0.006). The adjusted HRs of 1-year CV mortality were 1.533, 1.568, 1.609, and 2.710, respectively (p for trend = 0.015). RDW was an independent predicting factor and had a linear relationship with the 1-year all-cause and CV mortalities in patients undergoing PCI. Thus, RDW may be a clinically useful parameter to predict the mortality in those patients.
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Affiliation(s)
- Min-Tsun Liao
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 300, Taiwan;
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan; (J.-W.L.); (Y.-L.H.)
| | - Chao-Lun Lai
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 300, Taiwan;
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan; (J.-W.L.); (Y.-L.H.)
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 100, Taiwan
- Correspondence: ; Tel.: +886-3-5326151
| | - Ting-Chuan Wang
- Health Data Research Center, National Taiwan University, Taipei 100, Taiwan; (T.-C.W.); (K.A.C.)
| | - Jou-Wei Lin
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan; (J.-W.L.); (Y.-L.H.)
- Cardiovascular Center, National Taiwan University Hospital Yunlin Branch, Douliu City 640, Taiwan
| | - Yi-Lwun Ho
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan; (J.-W.L.); (Y.-L.H.)
- Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
| | - K. Arnold Chan
- Health Data Research Center, National Taiwan University, Taipei 100, Taiwan; (T.-C.W.); (K.A.C.)
- Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei 100, Taiwan
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