Document Detail


Validation and potential mechanisms of red cell distribution width as a prognostic marker in heart failure.
MedLine Citation:
PMID:  20206898     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Adverse outcomes have recently been linked to elevated red cell distribution width (RDW) in heart failure. Our study sought to validate the prognostic value of RDW in heart failure and to explore the potential mechanisms underlying this association.
METHODS AND RESULTS: Data from the Study of Anemia in a Heart Failure Population (STAMINA-HFP) registry, a prospective, multicenter cohort of ambulatory patients with heart failure supported multivariable modeling to assess relationships between RDW and outcomes. The association between RDW and iron metabolism, inflammation, and neurohormonal activation was studied in a separate cohort of heart failure patients from the United Investigators to Evaluate Heart Failure (UNITE-HF) Biomarker registry. RDW was independently predictive of outcome (for each 1% increase in RDW, hazard ratio for mortality 1.06, 95% CI 1.01-1.12; hazard ratio for hospitalization or mortality 1.06; 95% CI 1.02-1.10) after adjustment for other covariates. Increasing RDW correlated with decreasing hemoglobin, increasing interleukin-6, and impaired iron mobilization.
CONCLUSIONS: Our results confirm previous observations that RDW is a strong, independent predictor of adverse outcome in chronic heart failure and suggest elevated RDW may indicate inflammatory stress and impaired iron mobilization. These findings encourage further research into the relationship between heart failure and the hematologic system.
Authors:
Larry A Allen; G Michael Felker; Mandeep R Mehra; Jun R Chiong; Stephanie H Dunlap; Jalal K Ghali; Daniel J Lenihan; Ron M Oren; Lynne E Wagoner; Todd A Schwartz; Kirkwood F Adams
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2009-12-29
Journal Detail:
Title:  Journal of cardiac failure     Volume:  16     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-08     Completed Date:  2010-06-07     Revised Date:  2014-01-24    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  230-8     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood*
Cause of Death*
Cohort Studies
Erythrocyte Indices*
Erythrocytes / cytology*
Erythropoiesis / physiology
Female
Heart Failure / blood*,  diagnosis,  mortality*
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Probability
Prognosis
Proportional Hazards Models
Registries
Risk Assessment
Survival Analysis
Grant Support
ID/Acronym/Agency:
T32 HL069749/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers

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