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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2016
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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 |
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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 |
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