Red Blood Cell Distribution Width As A Prognostic Marker For Patients With Chronic Heart Failure

Objectives: To evaluate whether the red blood cell distribution width can be used to predict the prognosis for patients with chronic heart failure.Methods: A total of 200 patients who were hospitalized in our medical center and disgnosis as chronic heart failure between June 2009 and June 2010 were followed in our intensive heart failure out paitent clinic untiloctober 2010.(man 125, NYHAII 33, NYHAIII 114, NYHA IV 53). Analyse the difference of RDW between the dead group and the survival group.200 paitents were divided into four groups by quartile RDW. Chi square and t-test was performed to test the differences between the two groups. Kaplan-Meier survival curves and a log-rank test were used to compare mortality between groups. The association between RDW and survival was assessed using Cox's proportional hazards analysis.And plotting the RDW ROC curve to evaluation the sensitivity and specificity of CHF.Result: 200patients were enrolled, In the dead group the average age was higher(76.66±8.86 vs 70.32±12.64,P<0.05),the dead group have higher level of RDW(16.46±2.35 vs 14.10±1.19,P<0.05). The haemoglobin concentration is lower in dead group(114.38±15.29 vs 130.55±18.55,P<0.05). With correlation Analysis the RDW have correlation with LogNT-ProBNP, Uric acid ,haemoglobin (OR 0.267 , -0.221, 0.198, 0.148 P<0.05).The RDW of CHF was higher than The normal group. Using multivariable COX's proportional hazards analysis methos, different independently parameters were analyzed to evaluate their role to predict prognosis for patients with chronic heart failure, among which both NT-proBNP and RDW (hazard ratio,1.905;95% confidence interval,1.043-1.873 P<0.05)appeared to be the most valuable marker to predict the survival rate for this specific group of patient in our hospital. The best level of RDW to value the prognosis of chronic heart failure patients is higher than 14.35,The sensitive and the speciality are 68.75%,62.50%.Kaplan-Meier survival analysis revealed that patients with RDW levels >14.35 and NT-ProBNP levels >6598pg/mL were at highest mortality (P<0.001).Conclusions: RDW values independently predicted short term mortality in chronic heart failure, and is superior to haemoglobin concentration and old age. Combination of RDW and NT-ProBNP is a more useful prognostic marker for short-term clinical outcomes in patients with chronic heart failure.