Cargando…

Red cell distribution width and mortality in acute heart failure patients with preserved and reduced ejection fraction

BACKGROUND: Elevated red blood cell distribution width (RDW) is a valid predictor of outcome in acute heart failure (AHF). It is unknown whether elevated RDW remains predictive in AHF patients with either preserved left ventricular ejection fraction (LVEF) ≥50% or reduced LVEF (<50%). METHODS AND...

Descripción completa

Detalles Bibliográficos
Autores principales: Sotiropoulos, Konstantinos, Yerly, Patrick, Monney, Pierre, Garnier, Antoine, Regamey, Julien, Hugli, Olivier, Martin, David, Metrich, Melanie, Antonietti, Jean‐Philippe, Hullin, Roger
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5074265/
https://www.ncbi.nlm.nih.gov/pubmed/27818784
http://dx.doi.org/10.1002/ehf2.12091
_version_ 1782461701710413824
author Sotiropoulos, Konstantinos
Yerly, Patrick
Monney, Pierre
Garnier, Antoine
Regamey, Julien
Hugli, Olivier
Martin, David
Metrich, Melanie
Antonietti, Jean‐Philippe
Hullin, Roger
author_facet Sotiropoulos, Konstantinos
Yerly, Patrick
Monney, Pierre
Garnier, Antoine
Regamey, Julien
Hugli, Olivier
Martin, David
Metrich, Melanie
Antonietti, Jean‐Philippe
Hullin, Roger
author_sort Sotiropoulos, Konstantinos
collection PubMed
description BACKGROUND: Elevated red blood cell distribution width (RDW) is a valid predictor of outcome in acute heart failure (AHF). It is unknown whether elevated RDW remains predictive in AHF patients with either preserved left ventricular ejection fraction (LVEF) ≥50% or reduced LVEF (<50%). METHODS AND RESULTS: Prospective local registry including 402 consecutive hospitalized AHF patients without acute coronary syndrome or need of intensive care. The primary outcome was all‐cause mortality (ACM) at 1 year after admission. Demographic and clinical data derive from admission, echocardiographic examinations (n = 269; 67%) from hospitalization. The Cox proportional hazard model including all patients (P < 0.001) was adjusted for age, gender, and RDW quartiles. Independent predictors of 1‐year ACM were cardiogenic shock (HR 2.86; CI: 1.3–6.4), male sex (HR 1.9; CI: 1.2–2.9), high RDW quartile (HR 1.66; CI: 1.02–2.8), chronic HF (HR 1.61; CI: 1.05–2.5), valvular heart disease (HR 1.61; CI: 1.09–2.4), increased diastolic blood pressure (HR 1.02 per mmHg; CI: 1.01–1.03), increasing age (HR 1.04 by year; CI: 1.02–1.07), platelet count (HR 1.002 per G/l; CI: 1.0–1.004), systolic blood pressure (HR 0.99 per mmHg; CI: 0.98–0.99), and weight (HR 0.98 per kg; CI: 0.97–0.99). A total of 114 patients (28.4%) died within the first year; ACM of all patients increased with quartiles of rising RDW (χ(2) 18; P < 0.001). ACM was not different between RDW quartiles of patients with reduced LVEF (n = 153; χ(2) 6.6; P = 0.084). In AHF with LVEF ≥50% the probability of ACM increased with rising RDW (n = 116; χ(2) 9.9; P = 0.0195). CONCLUSIONS: High RDW is associated with increased ACM in AHF patients with preserved but not with reduced LVEF in this study population.
format Online
Article
Text
id pubmed-5074265
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-50742652016-11-04 Red cell distribution width and mortality in acute heart failure patients with preserved and reduced ejection fraction Sotiropoulos, Konstantinos Yerly, Patrick Monney, Pierre Garnier, Antoine Regamey, Julien Hugli, Olivier Martin, David Metrich, Melanie Antonietti, Jean‐Philippe Hullin, Roger ESC Heart Fail Original Research Articles BACKGROUND: Elevated red blood cell distribution width (RDW) is a valid predictor of outcome in acute heart failure (AHF). It is unknown whether elevated RDW remains predictive in AHF patients with either preserved left ventricular ejection fraction (LVEF) ≥50% or reduced LVEF (<50%). METHODS AND RESULTS: Prospective local registry including 402 consecutive hospitalized AHF patients without acute coronary syndrome or need of intensive care. The primary outcome was all‐cause mortality (ACM) at 1 year after admission. Demographic and clinical data derive from admission, echocardiographic examinations (n = 269; 67%) from hospitalization. The Cox proportional hazard model including all patients (P < 0.001) was adjusted for age, gender, and RDW quartiles. Independent predictors of 1‐year ACM were cardiogenic shock (HR 2.86; CI: 1.3–6.4), male sex (HR 1.9; CI: 1.2–2.9), high RDW quartile (HR 1.66; CI: 1.02–2.8), chronic HF (HR 1.61; CI: 1.05–2.5), valvular heart disease (HR 1.61; CI: 1.09–2.4), increased diastolic blood pressure (HR 1.02 per mmHg; CI: 1.01–1.03), increasing age (HR 1.04 by year; CI: 1.02–1.07), platelet count (HR 1.002 per G/l; CI: 1.0–1.004), systolic blood pressure (HR 0.99 per mmHg; CI: 0.98–0.99), and weight (HR 0.98 per kg; CI: 0.97–0.99). A total of 114 patients (28.4%) died within the first year; ACM of all patients increased with quartiles of rising RDW (χ(2) 18; P < 0.001). ACM was not different between RDW quartiles of patients with reduced LVEF (n = 153; χ(2) 6.6; P = 0.084). In AHF with LVEF ≥50% the probability of ACM increased with rising RDW (n = 116; χ(2) 9.9; P = 0.0195). CONCLUSIONS: High RDW is associated with increased ACM in AHF patients with preserved but not with reduced LVEF in this study population. John Wiley and Sons Inc. 2016-04-08 /pmc/articles/PMC5074265/ /pubmed/27818784 http://dx.doi.org/10.1002/ehf2.12091 Text en © 2016 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research Articles
Sotiropoulos, Konstantinos
Yerly, Patrick
Monney, Pierre
Garnier, Antoine
Regamey, Julien
Hugli, Olivier
Martin, David
Metrich, Melanie
Antonietti, Jean‐Philippe
Hullin, Roger
Red cell distribution width and mortality in acute heart failure patients with preserved and reduced ejection fraction
title Red cell distribution width and mortality in acute heart failure patients with preserved and reduced ejection fraction
title_full Red cell distribution width and mortality in acute heart failure patients with preserved and reduced ejection fraction
title_fullStr Red cell distribution width and mortality in acute heart failure patients with preserved and reduced ejection fraction
title_full_unstemmed Red cell distribution width and mortality in acute heart failure patients with preserved and reduced ejection fraction
title_short Red cell distribution width and mortality in acute heart failure patients with preserved and reduced ejection fraction
title_sort red cell distribution width and mortality in acute heart failure patients with preserved and reduced ejection fraction
topic Original Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5074265/
https://www.ncbi.nlm.nih.gov/pubmed/27818784
http://dx.doi.org/10.1002/ehf2.12091
work_keys_str_mv AT sotiropouloskonstantinos redcelldistributionwidthandmortalityinacuteheartfailurepatientswithpreservedandreducedejectionfraction
AT yerlypatrick redcelldistributionwidthandmortalityinacuteheartfailurepatientswithpreservedandreducedejectionfraction
AT monneypierre redcelldistributionwidthandmortalityinacuteheartfailurepatientswithpreservedandreducedejectionfraction
AT garnierantoine redcelldistributionwidthandmortalityinacuteheartfailurepatientswithpreservedandreducedejectionfraction
AT regameyjulien redcelldistributionwidthandmortalityinacuteheartfailurepatientswithpreservedandreducedejectionfraction
AT hugliolivier redcelldistributionwidthandmortalityinacuteheartfailurepatientswithpreservedandreducedejectionfraction
AT martindavid redcelldistributionwidthandmortalityinacuteheartfailurepatientswithpreservedandreducedejectionfraction
AT metrichmelanie redcelldistributionwidthandmortalityinacuteheartfailurepatientswithpreservedandreducedejectionfraction
AT antoniettijeanphilippe redcelldistributionwidthandmortalityinacuteheartfailurepatientswithpreservedandreducedejectionfraction
AT hullinroger redcelldistributionwidthandmortalityinacuteheartfailurepatientswithpreservedandreducedejectionfraction