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Red blood cell distribution width predicts new-onset anemia in heart failure patients.
MedLine Citation:
PMID:  21555160     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Hematologic abnormalities such as elevated red blood cell distribution width (RDW) as well as anemia are prognostically meaningful among heart failure (HF) patients. The inter-relationship between these hematologic abnormalities in HF is unclear, however. We therefore aimed to assess whether RDW is predicting changes in hemoglobin concentrations as well as onset of anemia. METHODS: 268 consecutive non-anemic patients with acutely decompensated HF (ADHF) were enrolled at hospital discharge and RDW was measured. At 6month follow-up, change in hemoglobin as well as new-onset anemia was studied as a function of RDW at discharge. RESULTS: RDW at discharge correlated negatively with hemoglobin values at 6months (r=-0.220; p<0.001); a greater decrease in hemoglobin concentration occurred in those with higher values of RDW at discharge (p=0.004), independently of baseline hemoglobin concentration and other risk factors. At 6months, 54 patients (20%) developed new-onset anemia. RDW values at discharge were significantly higher among patients who developed new-onset anemia (15.1±2.2 vs. 14.2±1.4, p=0.005). In integrated discrimination improvement analyses, the addition of RDW measurement improved the ability to predict new-onset anemia (IDI 0.0531, p<0.001), beyond known risk factors as hemoglobin, renal function, age, diabetes mellitus, sex and HF symptom severity. In adjusted analyses, patients with RDW>15% (derived from receiver operating characteristic analysis) had a tripling of the risk of new-onset anemia (OR=3.1, 95% CI 1.5-5.1, p=0.002). CONCLUSION: Among non-anemic patients with ADHF, RDW measurement at the time of hospital discharge independently predicts lower hemoglobin concentrations and new-onset anemia over a 6-month follow up period.
Authors:
Domingo A Pascual-Figal; Juan C Bonaque; Sergio Manzano-Fernández; Asunción Fernández; Iris P Garrido; Francisco Pastor-Perez; Antonio Lax; M Valdes; James L Januzzi
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-7
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Cardiology Service, Virgen de la Arrixaca Hospital, School of Medicine, University of Murcia, Murcia, Spain.
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