Red cell distribution width as a new prognostic marker in patients with acute heart failure

Abstract

Background: Red cell distribution width (RDW) is discovered to be a novel prognostic and predictive marker in heart failure patients. We tested whether serial measurements of RDW would have prognostic importance in patients with acute heart failure (AHF).Methods: We analyzed laboratory findings and echocardiographic parameters in 140 hospitalized AHF patients (71 males, 62.8 ± 14.0 years old). RDW was measured on admission, at discharge and at 1-month after discharge. We assessed cardiovascular (CV) events, defined as CV mortality and HF rehospitalization during 1-year. Results: Mean RDW change between admission and discharge (RDWΔadm-dis) and 1-month after discharge (RDWΔadm-1Mdis) were -0.77 ± 1.58 % and -0.06 ± 1.19 %. The Kaplan-Meier analysis showed that patients with positive RDWΔadm-1Mdis (n = 62) had a significantly higher CV events compared with patients with negative or no RDWΔadm-1Mdis (n = 78) (51.6 % vs 28.2 %, log-rank: p = 0.005) but there were no significant differences in CV events between positive RDWΔadm-dis and negative or no RDWΔadm-dis (38.8 % vs 33.3 %, p = 0.41). The positive RDWΔadm-1Mdis was an independent predictor of CV events after adjusting other CV risk factors (hazard ratio : 4.61, 95 % CI 2.05 - 10.37, p < 0.001) in Cox proportional hazards regression analysis.Conclusion: These findings suggest that positive RDWΔadm-1Mdis is an independent prognostic marker in AHF patients. Therefore, the serial measurements of RDW, its simple, inexpensive method may help risk stratification in patients with AHF.