Higher red cell distribution width was strongly associated with increased morbidity and mortality in chronic heart failure patients (adjusted HR 1.17 per 1-SD increase, p<0.001).
Cohort (n=4,819)
Yes
Does higher red cell distribution width (RDW) predict morbidity and mortality in patients with symptomatic chronic heart failure?
Red cell distribution width (RDW) is a powerful, independent prognostic marker for morbidity and mortality in patients with chronic heart failure.
Effect estimate: HR 1.17
p-value: p=<0.001
OBJECTIVES: The goal of this study was to identify potentially novel laboratory markers of risk in chronic heart failure patients. BACKGROUND: Although a variety of prognostic markers have been described in heart failure, a systematic assessment of routine laboratory values has not been reported. METHODS: All 2,679 symptomatic chronic heart failure patients from the North American CHARM (Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity) program had a wide range of laboratory measures performed at a core facility, enabling us to assess the relationship between routine blood tests and outcomes using a Cox proportional hazards model. We then replicated our findings in a cohort of 2,140 heart failure patients from the Duke Databank. RESULTS: Among 36 laboratory values considered in the CHARM program, higher red cell distribution width (RDW) showed the greatest association with morbidity and mortality (adjusted hazard ratio 1.17 per 1-SD increase, p < 0.001). Higher RDW was among the most powerful overall predictors, with only age and cardiomegaly showing a better independent association with outcome. This finding was replicated in the Duke Databank, in which higher RDW was strongly associated with all-cause mortality (adjusted hazard ratio 1.29 per 1 SD, p < 0.001), second only to age as a predictor of outcome. CONCLUSIONS: In 2 large contemporary heart failure populations, RDW was found to be a very strong independent predictor of morbidity and mortality. Understanding how and why this marker is associated with outcome may provide novel insights into heart failure pathophysiology.
Felker et al. (Tue,) conducted a cohort in Chronic heart failure (n=4,819). Red cell distribution width (RDW) was evaluated on Morbidity and mortality (HR 1.17, p=<0.001). Higher red cell distribution width was strongly associated with increased morbidity and mortality in chronic heart failure patients (adjusted HR 1.17 per 1-SD increase, p<0.001).