The Clinical Value Of Red Cell Distribution Width In Severity And Prognosis Of Patients With Heart Failure

PURPOSEHeart failure is the final stage of various heart diseases,which has the characteristics of high morbidity and mortality,seriously threatens human health.Therefore,early risk stratification and prognosis it’s particularly important to assess patients who with heart failure.In recent years,more and more researchers have paid attention to the emerging markers of heart failure.Erythrocyte distribution width(RDW),as a routine item of blood examination,has been used to differentiate different types of anemia.With the deepening of research,the feasibility of RDW in predicting cardiovascular disease has been confirmed by more and more researchers.RDW has the clinical characteristics of convenience,simplicity and low cost.It is easy to popularize and apply in primary hospitals,and greatly improves the diagnostic rate of heart failure patients.Monitoring RDW can achieve early risk stratification of heart failure patients,so as to achieve early diagnosis,early intervention,early prevention and treatment,timely identification of high-risk patients and improve the quality of life of patients,and provide more reference for clinical practice.In this study,we retrospectively analyzed the value of RDW level and clinical indicators in evaluating the severity and prognosis of patients with heart failure,and explored the potential mechanism of RDW as a predictor of the prognosis of heart failure.METHODSThis study select 200 patients with heart failure who were hospitalized in the First Affiliated Hospital of Henan University from December 1,2017 to December 31,2018,including 119 males and 81 females,and 111 non-heart failure patients from the Department of Cardiology of Henan University,including 66 males and 45 females.We collected the general information of the patients and examined them with fasting venous blood and auxiliary imaging.Excel software was recorded and SPSS19.0 was used for statistical analysis.Independent sample T test was used to compare the differences of various indicators between heart failure group and control group.Heart failure group was graded according to the New York Heart Association(NYHA)grading standard.The differences of factors among different grading groups were compared by one-way ANOVA,and analyze the relationship between RDW and risk stratification of cardiac function.The patients with heart failure were divided into three groups according to the level of RDW.The correlation between the level of RDW and the severity of heart failure was analyzed by variance analysis.Pearson correlation test was used to analyze the correlation between RDW and other factors.Heart failure patients were divided into event group and non-event group according to whether cardiovascular adverse events occurred or not.Kaplan-Meier survival curve analysis was carried out between the two groups to compare the differences of survival curve between patients with different RDW levels,and to clarify the relationship between RDW and survival time of patients with heart failure.COX proportional risk regression model was used to analyze the independent influencing factors of cardiovascular adverse events in patients with heart failure,in order to realize the early prediction of the occurrence and development of heart failure,and to provide effective basis for early intervention and treatment.RESULTS1 There were differences in age,RDW,NT-ProBNP,EF%,BUN,Scr,ALT,AST,GGT,TC,TG and LDL between the heart failure group and the control group(P < 0.05),the heart failure group was different from the control group in these indicators.2 Compared with two groups of different NYHA grading,RDW levels were significantly different in different cardiac function grading groups,and there was a positive correlation(P < 0.001),the higher the cardiac function grading,the higher the RDW level.3 There were significant differences in NT-ProBNP,EF%,BUN,ALT,AST and GGT between groups with low,medium and high RDW levels(P < 0.05).4 RDW is correlated with NT-Pro BNP,BUN,Scr,GGT and LVEF%.RDW was positively correlated with NT-Pro BNP,BUN,Scr and GGT,and negatively correlated with LVEF%.5 There were significant differences in age,NT-ProBNP,RDW,EF%,BUN,ALT and AST between event group and non-event group(P < 0.05).Age,RDW and NT-ProBNP were independent risk factors for death in CHF group(P < 0.05).6 The ROC curves of age,RDW and NT-ProBNP were analyzed.The results showed that there were significant differences among groups with low,medium and high RDW levels(P < 0.05).7 Kaplan-Meier survival curve analysis showed that the survival rates of patients with different RDW levels were significantly different,and the difference was extremely significant(P < 0.001),the incidence of adverse cardiovascular events in patients with heart failure with high RDW levels increased.