Higher red cell distribution width was associated with progression of carotid atherosclerosis over 7 years, with a 1% increase in RDW linked to a 0.6 mm² increase in total plaque area (P=0.03).
Cohort (n=4,677)
Does higher red cell distribution width (RDW) predict progression of carotid atherosclerosis in the general population?
Higher red cell distribution width is independently associated with the progression of carotid atherosclerosis, suggesting a mechanistic link between RDW and cardiovascular morbidity.
Mean Difference: 0.6 (95% CI 0.1–1.2)
Absolute Event Rate: 6.7% vs 5.6%
p-value: p=0.03
Red cell distribution width (RDW), a measure of the size variability of circulating erythrocytes, is associated with cardiovascular morbidity and mortality. We aimed to investigate whether RDW was associated with progression of atherosclerotic plaques in subjects recruited from the general population. Baseline characteristics, including RDW, were collected from 4677 participants in the fourth survey of the Tromsø Study conducted in 1994/95. Prevalence of carotid plaques and total plaque area (TPA) were assessed by ultrasonographic imaging at baseline and after seven years of follow-up. Generalised linear models were used to analyse change in TPA across tertiles of RDW. Change in TPA was significantly higher across tertiles of RDW in crude analysis and in multivariable analysis adjusted for cardiovascular risk factors. The mean change in TPA increased from 5.6 mm² (4.9-6.4) in tertile 1 (RDW ≤ 12.6 %) to 6.7 mm² (5.9-7.6) in tertile 3 (RDW ≥ 13.3) in multivariable analysis adjusted for body mass index, total cholesterol, HDL cholesterol, systolic blood pressure, self-reported diabetes, smoking status, platelet count, white blood cell count, and hs-CRP levels (p for trend 0.003). A 1 % increase in RDW was associated with 0.6 mm² (0.1-1.2) increase in TPA in multivariable analysis (p=0.03). RDW was associated with progression of atherosclerosis after adjustments for traditional atherosclerotic risk factors. Our findings suggest that the link between RDW and cardiovascular morbidity and mortality may be explained by atherosclerosis.
Ellingsen et al. (2015) conducted a cohort in Carotid atherosclerosis (n=4,677). Red cell distribution width (RDW) vs. Lower RDW (tertile 1) was evaluated on Change in total plaque area (TPA) (MD 0.6, 95% CI 0.1-1.2, p=0.03). Higher red cell distribution width was associated with progression of carotid atherosclerosis over 7 years, with a 1% increase in RDW linked to a 0.6 mm² increase in total plaque area (P=0.03).