Red Cell Distribution Width and Severe Left Ventricular Dysfunction in Ischemic Heart Failure Publisher Pubmed



Bozorgi A¹ ; Nasab EM² ; Khoshnevis M² ; Dogmehchi E³ ; Hamze G⁴ ; Goodarzynejad H⁵ Show Affiliations
Source: Critical Pathways in Cardiology Published:2016

Abstract

Objective: The red cell distribution width (RDW), a simple and widely available marker, has been linked with an increased risk of adverse outcomes in patients with heart failure (HF) and risk of death, and cardiovascular events in those with previous myocardial infarction, but its relation with the severity of left ventricular (LV) dysfunction is not fully investigated. The aim of this study was to assess the prognostic value of the RDW in post myocardial infarction patients with typical signs and symptoms of HF and with reduced LV ejection fraction (EF). Methods: Patients (n = 350) came from an ongoing registry of consecutive patients who admitted for ischemic heart disease at our center. All patients were followed up 1 year after the initial hospitalization by telephone interviews. The outcomes studied were mortality and hospitalization because of decompensated HF. Results: RDW-coeffcient of variation (express in percentage) was calculated from SD of mean corpuscular volume and mean corpuscular volume itself. Using logistic regression analysis, 3 variables consisting age, RDW level, and hemoglobin were identifed as independent predictors of severe LV dysfunction (LVEF <30%). Levels of RDW were associated with the presence of severe LV dysfunction, with an accuracy of 61.4% (95% confdence interval: 56.2%-66.4%) and 66.9% (95% confdence interval: 61.8%-71.6%), using cut-off values of higher than 13.5 and 13.8, respectively. Conclusion: Our results suggest that elevated RDW may be used as a prognostic tool among HF patients with the documented myocardial infarction because it is an inexpensive, rapidly calculated test that is already routinely in use in practice. © 2016 Wolters Kluwer Health, Inc. All rights reserved.