| Background and Objective:Heart failure (HF) is one of the global public health problems which haveimportant influence on human health. Hence it is essential to make accurate riskstratification and prognosis for the patients, to screen high-risk populations haveimportant implications for the treatment of patients with heart failure. Red blood celldistribution width (RDW) is a measure of the variability in the size of circulatingerythrocytes, which can be used in the classification of anemia. In recent years, moreand more studies have shown that RDW is a risk stratification and powerfulprognostic indicator for patients with heart failure. In this study, we compared theRDW level in our heart failure case-control population, and combined the alreadyknown heart failure marker to analysis the important value of RDW in heart failureseverity and prognosis.Methods:We retrospectively investigated consecutive patients who visited the cardiologydepartment of China-Japan Union Hospital from January to June in2013. Accordingto the inclusion and exclusion criteria, a total of240heart failure patients wereenrolled in the case group. There were102male patients and138female patients. Inaccordance with the New York Heart Association (NYHA) classification, there areeach80patients in the NYHA II, NYHA III and NYHA IV group. We selected200patients without heart failure in our hospital as the control group, including110malepatients and90female patients. For each patient, detailed records of the patient’s age,gender, BMI, and so on. And fasting blood taken within24hours after admission ofall enrolled patients to measured serum creatinine, blood urea nitrogen, brainnatriuretic peptide, and left ventricular ejection fraction (LVEF) was measured withechocardiography.Results:1.Compared with the control group, RDW level was significantly higher in theheart failure group (P<0.001). The RDW level was increased as the NYHA classification grade. There is a correlation between RDW and LVEF as well aslog[NT-proBNP], the RDW was significantly positive correlated with LVEF(r=-0.481,P<0.05) and negative correlated with log[NT-proBNP](r=0.0637,P<0.001).2.The RDW level, LVEF, eGFR and log [NT-proBNP] was significantly differentbetween the cardiovascular events group and non-events group, and the COXregression analysis showed that RDW and Log [NT-proBNP] are independent factorsaffecting the cardiovascular events.3.ROC analysis showed that there is no significant different between the RDWand Log [NT-proBNP] when using the Z test to measure the area under the curve(P>0.05). While when using the Kaplan-Meier survival curve analysis, selectRDW13.85%as cutoff to compare for the survival time of readmission, the incidenceof cardiovascular events. Significant differences was found between all these groups(P <0.001); RDW quartile grouped by comparing survival time increased with RDW,gradually shortened survival time, a significant difference (P <0.001) between thesurvival curves.4.When using quartile grouped methods to compare the cardiovascular events ineach group, we found that at the Q2stage the RDW is more effective to predict all thecardiovascular events compared with log[NT-proBNP]Conclusion:RDW is significantly higher in patients with heart failure, and is significantlyelevated with NYHA class severity. RDW is negatively correlated with LVEF, and ispositively correlated with log[NT-proBNP]. Therefore, RDW may act as an importantindicator to determine the severity of the patient and as a powerful prognostic markerto evaluate the cardiovascular events in heart failure patients. |
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