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Martins CMDH, Monteiro Júnior JGDM, Torres DDOC, Sobral Filho DC, Morais MCS, Montarroyos UR, Silva IKD, Santos ACOD. Hematological Changes during Seven Days of Hospitalization in Patients with Acute Myocardial Infarction. Arq Bras Cardiol 2023; 120:e20230045. [PMID: 37937582 DOI: 10.36660/abc.20230045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/16/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Acute myocardial infarction is a major cause of mortality worldwide, and atherosclerotic plaque formation is the main pathophysiological mechanism, which results in chronic inflammation that induces erythrocyte maturation and may cause an increase in the red cell distribution width (RDW) index. OBJECTIVE Evaluate the role of the anisocytosis index in patients with acute myocardial infarction in both types of infarctions as a predictor of severity. METHODS Patients were included in the study according to the inclusion/exclusion criteria, following the hospital routine based on their clinical and laboratory history. Statistical analyzes were performed according to each variable. All conclusions were drawn considering the significance level of 5%. RESULTS During the follow-up period, in the 349 patients analyzed, the mortality rate was associated with the variables RDW (CV) and RDW (SD), in those patients who died, an increase was noted, as demonstrated in the multivariate model, for the effects of an acute ST elevation myocardial infarction and the RDW, adjusted for confounding factors (p-value = 0.03 and 0.04). In contrast, the total number of erythrocytes (p-value = 0.00) and hemoglobin (p-value = 0.03) showed a decrease during severe patients' hospitalization. CONCLUSION The anisocytosis index was a predictive factor of mortality and can be used as an indicator of worse prognosis in patients with acute myocardial infarction.
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Affiliation(s)
| | - José Gildo de Moura Monteiro Júnior
- Pronto Socorro Cardiológico de Pernambuco (PROCAPE-UPE), Recife, PE - Brasil
- Faculdade de Ciências Médicas - Universidade de Pernambuco (FCM-UPPE), Recife, PE - Brasil
| | | | - Dario Celestino Sobral Filho
- Pronto Socorro Cardiológico de Pernambuco (PROCAPE-UPE), Recife, PE - Brasil
- Faculdade de Ciências Médicas - Universidade de Pernambuco (FCM-UPPE), Recife, PE - Brasil
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Miglio A, Valente C, Guglielmini C. Red Blood Cell Distribution Width as a Novel Parameter in Canine Disorders: Literature Review and Future Prospective. Animals (Basel) 2023; 13:ani13060985. [PMID: 36978525 PMCID: PMC10044289 DOI: 10.3390/ani13060985] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
Red blood cell distribution width (RDW) is a quantitative laboratory parameter applied for the measurement of anisocytosis and is a reliable and inexpensive method for clinical classification of anemia. An increased RDW reflects a great heterogeneity in the size of red blood cells typical of regenerative and iron-deficiency anemia. In humans, numerous and recent studies have shown a relationship between increased RDW and the risk of morbidity and mortality in patients with various disorders. In particular, a strong association has been established between changes in RDW and the risk of adverse outcome in humans with diseases affecting different organs or systems. Following the human literature, some studies have recently been conducted trying to clarify the clinical role of RDW in various animal disorders, particularly in dogs. In this review, we summarize and critically evaluate the results of the studies based on the measurement of RDW in dogs. We also emphasize the need for further and more extensive studies on the use of this simple and inexpensive parameter in animals.
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Affiliation(s)
- Arianna Miglio
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy;
| | - Carlotta Valente
- Department of Animal Medicine, Production and Health, University of Padua, Viale dell’Università 16, 35020 Legnaro, Italy;
| | - Carlo Guglielmini
- Department of Animal Medicine, Production and Health, University of Padua, Viale dell’Università 16, 35020 Legnaro, Italy;
- Correspondence:
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Red Cell Distribution Width as a Novel Predictor of Mortality and Complications After Primary Shoulder Arthroplasty. J Am Acad Orthop Surg 2020; 28:802-807. [PMID: 31842062 DOI: 10.5435/jaaos-d-19-00499] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Variability in red blood cell volume can occur in disease states and is quantified using a simple equation, yielding the relative distribution of width (RDW). Recent literature has correlated RDW with outcomes in many cardiac disease states, hip fractures, and even revision hip arthroplasty. The association with outcomes in total shoulder arthroplasty (TSA) is yet to be delineated. The purpose of this study was to investigate the possible relationship between preoperative RDW levels and mortality and other adverse outcomes after primary TSA. METHODS Patients who underwent primary TSA and had RDW values on record were identified in a national database. Patients were then grouped by RDW, and the incidence of complications was calculated for each group, including mortality within 1 year, periprosthetic infection within 1 year, acute venous thromboembolism within 30 days, and readmission to a hospital within 30 days. A threshold value of RDW for increased complications was established using receiver operator characteristic (ROC) curves. RESULTS Five thousand two hundred forty-five patients who underwent TSA with a recorded RDW were included in the study. An RDW cutoff of 16% was found to be significantly associated with mortality at 1 year (P < 0.0001), readmission (P < 0.0001), and infection (P = 0.013) on ROC analysis. When controlling for demographic and comorbidity values, a high RDW was markedly associated with a higher mortality rate (odds ratio 2.0, 95% confidence interval 18 to 2.2) and readmission rate (odds ratio 1.5, 95% confidence interval 1.3 to 1.8). A high RDW was not markedly associated with increased infection or venous thromboembolism rate in the multivariate analysis. DISCUSSION Increasing preoperative RDW is associated with increasing complication rates after TSA. This value can be used as an indirect, real-time preoperative predictor of adverse outcomes and most importantly one-year mortality and hospital readmission. LEVEL OF EVIDENCE III retrospective cohort study.
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Paliogiannis P, Zinellu A, Mangoni AA, Capobianco G, Dessole S, Cherchi PL, Carru C. Red blood cell distribution width in pregnancy: a systematic review. Biochem Med (Zagreb) 2019; 28:030502. [PMID: 30429667 PMCID: PMC6214699 DOI: 10.11613/bm.2018.030502] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 07/13/2018] [Indexed: 11/06/2022] Open
Abstract
Anisocytosis has been associated with the severity and prognosis of several acute and chronic diseases, as well as physiological conditions such as pregnancy. Anisocytosis is quantified by the red blood cell distribution width (RDW), expressed as the ratio, multiplied by 100, between the standard deviation (SD) of red blood cell volumes and the mean corpuscular volume, or as the SD of erythrocyte volumes (RDW-SD). The aim of the present review was to report the state of the art on the physiological values and the putative diagnostic and prognostic roles of RDW in complicated pregnancy. Literature research for articles published in the last ten years was conducted in Pubmed, Web of Science, ClinicalTrials.gov, and Scopus databases. Abstracts were independently screened by two investigators. If relevant, full articles were retrieved. References, in these articles, citing relevant reviews or original studies were also accessed to identify additional eligible studies. Any disagreement between the reviewers was resolved by a third investigator. A total of 28 studies were included in the review. These studies reported changes in RDW values during physiological pregnancy, and associations between the RDW and several pregnancy complications including anaemia, preeclampsia, gestational diabetes, and recurrent miscarriage. This review provides background information for establishing physiological and pathological RDW values in pregnancy for diagnostic and prognostic use in clinical practice.
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Affiliation(s)
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Arduino A Mangoni
- Department of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Giampiero Capobianco
- Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Salvatore Dessole
- Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Pier Luigi Cherchi
- Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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Lee KR, Park SO, Kim SY, Hong DY, Kim JW, Baek KJ, Shin DH, Lee YH. Red cell distribution width as a novel marker for predicting high-risk from upper gastro-intestinal bleeding patients. PLoS One 2017; 12:e0187158. [PMID: 29095860 PMCID: PMC5667835 DOI: 10.1371/journal.pone.0187158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 10/14/2017] [Indexed: 01/01/2023] Open
Abstract
Background In upper gastrointestinal bleeding (UGIB) patients, early risk stratification allows appropriate therapy that may be helpful for reducing morbidity and mortality. Objectives to evaluate the efficacy of red-cell distribution width (RDW) for prediction of high-risk in UGIB patients. Methods We conducted a clinical retrospective observational study based on data for UGIB patients from 2012 to 2013. The primary outcome was the high-risk UGIB, defined as those who required urgent intervention and/or 30-days mortality. RDW was categorized into four quartiles: Q1 (≤12.8%), Q2 (12.9–14.4%), Q3 (14.5–16.5%), and Q4 (≥16.6%), and multivariable analysis was performed after adjustment of multiple other risk factor. We also evaluated the efficacy of addition of RDW scores to the Pre-endoscopic Rockall Score (PRS) and the Glasgow Blatchford Score (GBS) scoring system. Results Of 360 UGIB patients, 229 (63.6%) were high risk. In multivariable analysis, Q3 and Q4 were strongly associated with high risk; odds ratio (95% Confidence Interval) was 3.144 (1.250–7.905) and 4.182 (1.483–11.790) respectively (all p < 0.05). For lower GBS score group (≤ 6), the incidence of high risk was higher in Q4 (30%) and Q3 (20%) than in Q2 (12.5%) and Q1 (11.4%). For lower PRS group (≤ 2), the incidence of high-risk was higher in Q4 (73.7%) and Q3 (57.1%) than in Q1 (35.4%). Receiver operating characteristic analysis showed higher discrimination power in PRS + RDW (Area Under Curve [AUC] = 0.749) than PRS (AUC = 0.715) alone (p = 0.036). Otherwise GBS + RDW (AUC = 0.873) did not show a significant higher discrimination power than the GBS (AUC = 0.864) alone (p = 0.098). Conclusions For UGIB patients, a high RDW (≥ 14.5%) was strongly associated with high risk UGIB. In practice, the combination of RDW with the PRS scoring indexes may increase the accuracy of risk stratification.
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Affiliation(s)
- Kyeong Ryong Lee
- Department of Emergency Medicine, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Sang O. Park
- Department of Emergency Medicine, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Republic of Korea
- * E-mail:
| | - Sin Young Kim
- Department of Emergency Medicine, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Dae Young Hong
- Department of Emergency Medicine, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Jong Won Kim
- Department of Emergency Medicine, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Kwang Je Baek
- Department of Emergency Medicine, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Dong Hyuk Shin
- Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Hwan Lee
- Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
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Costa EM, Azevedo JAP, Martins RFM, Alves CMC, Ribeiro CCC, Thomaz EBAF. Anemia and Dental Caries in Pregnant Women: a Prospective Cohort Study. Biol Trace Elem Res 2017; 177:241-250. [PMID: 27866358 DOI: 10.1007/s12011-016-0898-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 11/10/2016] [Indexed: 10/20/2022]
Abstract
The objective was to evaluate the effect of anemia during pregnancy on the risk of dental caries development in pregnant women. A prospective cohort including a sample of pregnant women in a prenatal care unit of São Luís, Brazil, was done. The incidence of dental caries during pregnancy, according to Nyvad's criteria, was the outcome. The main independent variables were serum iron, ferritin, hemoglobin, erythrocyte, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW). Pregnant women (n = 121) were evaluated at two moments: up to 16th week of gestational age (T1) and in the last trimester of pregnancy (T2). Crude and adjusted associations were estimated by the incidence ratio risk (IRR) and respective 95% confidence intervals (95%CI). After adjustment, higher serum concentrations of ferritin (IRR = 0.97, 95%CI 0.95-0.99) in T1, and Fe (IRR = 0.99, 95%CI 0.98-0.99), ferritin (IRR = 0.99, 95%CI 0.98-0.99), erythrocyte (IRR = 0.71, 95%CI 0.50-0.99), hemoglobin (IRR = 0.84, 95%CI 0.73-0.96), hematocrit (IRR = 0.93, 95%CI 0.88-0.98), MCV (IRR = 0.91, 95%CI 0.86-0.96), and MCH (IRR = 0.83, 95%CI 0.74-0.93) in T2, were associated with fewer incidence of dental caries in pregnant women. Iron deficiency anemia during pregnancy is a risk factor for the incidence of dental caries in these women.
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Affiliation(s)
- Elisa Miranda Costa
- Department of Public Health, Federal University of Maranhão, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão, Brazil.
| | - Juliana A P Azevedo
- Department of Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Rafiza F M Martins
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Cláudia M C Alves
- Department of Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Cecília C C Ribeiro
- Department of Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Erika B A F Thomaz
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
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Rayis DA, Ahmed MA, Abdel-Moneim H, Adam I, Lutfi MF. Trimester Pattern of Change and Reference Ranges of Hematological Profile Among Sudanese Women with Normal Pregnancy. Clin Pract 2017; 7:888. [PMID: 28243426 PMCID: PMC5264546 DOI: 10.4081/cp.2017.888] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 12/12/2016] [Accepted: 12/28/2016] [Indexed: 11/23/2022] Open
Abstract
Trimester specific reference ranges of hematological indices were described in several populations; however, comparable reports among Sudanese women with normal pregnancy are lacking. To evaluate trimester pattern of change and reference ranges of hematological profile among Sudanese women with normal pregnancy, we followed 143 women with singleton gestation since early pregnancy until the third trimester in Saad Abu-Alela Hospital, Khartoum, Sudan, during the period of January-December 2015. Obstetrics and medical history was gathered using questionnaire and hematological profile was investigated using hemo-analyser. The first, second and third trimester mean (SD) [5th-95th centile] of hematological profile were as follow: RBC counts 4.30 (0.36) [3.69-4.93], 4.35 (0.36) [3.69-4.93], 4.08 (0.44) [3.44-4.78] ×106/mm3; hemoglobin concentration 10.81 (1.22) [8.92-12.74], 10.62 (0.93) [9.00-12.10], 10.83 (1.13) [8.82-12.60] g/dL; hematocrit 35.38 (3.52) [30.12-40.30], 34.43 (2.51) [30.58-38.23], 35.17 (3.18) 29.66-40.04] %; WBC counts 7.69 (1.96) [4.36-11.20], 8.45 (1.97) [5.48-12.13], 8.36 (2.11) [5.00-11.96] ×103/mm3; platelet counts 278.02 (66.93) [182.6-418.0], 251.96 (64.17) [163.8-381.8], 238.36 (57.10) [150.4-346.2] ×103/mm3. The present study is the first to establish trimester specific, reference range for hematological profile among Sudanese women with normal pregnancy. The trimester reference range of RBC, WBC and platelets and other hematological indices are mostly parallel to international records.
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Affiliation(s)
- Duria A Rayis
- Department of Obstetrics and Gynecology, University of Khartoum , Sudan
| | - Mohamed A Ahmed
- Department of Obstetrics and Gynecology, University of Khartoum , Sudan
| | | | - Ishag Adam
- Department of Obstetrics and Gynecology, University of Khartoum , Sudan
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Sen-yu W, Chao X. Assessment of the relationship between red blood cell distribution width and preganecy hypertension disease. J Obstet Gynaecol Res 2016; 42:1258-1262. [PMID: 27436585 DOI: 10.1111/jog.13067] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 04/02/2016] [Accepted: 05/02/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Wang Sen-yu
- The Nuclear Medicine Departement; The Second Affiliated Hospital of Xinjiang Medical University; Urumqi China
| | - Xu Chao
- The Clinical Laboratory Department; The 98th Hospital of Chinese PLA; Urumqi China
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İlhan M, İlhan G, Gök AFK, Bademler S, Verit Atmaca F, Ertekin C. Evaluation of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and red blood cell distribution width-platelet ratio as early predictor of acute pancreatitis in pregnancy. J Matern Fetal Neonatal Med 2015; 29:1476-80. [PMID: 26043647 DOI: 10.3109/14767058.2015.1051026] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Acute pancreatitis (AP) is a state of inflammation. It has been widely known that neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and red blood cell distribution width (RDW) to platelet ratio (RPR) reflect systemic inflammation. The aim of this study is to investigate whether these inflammatory markers could be used as reliable markers in early prediction of AP in pregnancy and if there is a relationship between disease severity and these markers. METHODS The study group consisted of 14 patients, who developed AP in ongoing pregnancy, and the control group consisted of 30 healthy pregnant women. NLR, PLR and RPR were calculated for both the groups. RESULTS NLR was significantly elevated in the AP group when compared with the controls (p = 0.00), but there was no statistically significant difference in terms of PLR and RPR (p > 0.05). ROC curve analysis results for NLR showed that there was a significant prediction power of NLR for AP (R(2) = 0.842; p < 0.001). For NLR parameter, if cut-off value is chosen to be 4.1030, then sensitivity is 71.4% and specificity is 100.0%. There was statistically significant and positive correlation between C-reactive protein (CRP) and glucose with NLR (p = 0.001, p = 0.043). It was seen that Ranson was close to be significant (p = 0.051). CONCLUSION NLR might be used as an early marker of AP and may have a role in prediction of disease severity.
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Affiliation(s)
- Mehmet İlhan
- a Department of General Surgery, İstanbul Medical Faculty , İstanbul University , İstanbul , Turkey and
| | - Gülşah İlhan
- b Suleymaniye Research and Education Hospital , İstanbul , Turkey
| | - Ali Fuat Kaan Gök
- a Department of General Surgery, İstanbul Medical Faculty , İstanbul University , İstanbul , Turkey and
| | - Süleyman Bademler
- a Department of General Surgery, İstanbul Medical Faculty , İstanbul University , İstanbul , Turkey and
| | | | - Cemalettin Ertekin
- a Department of General Surgery, İstanbul Medical Faculty , İstanbul University , İstanbul , Turkey and
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Li W, Li X, Wang M, Ge X, Li F, Huang B, Peng J, Li G, Lu L, Yu Z, Ma J, Xu L, Jin M, Si H, Wan R. Association between red cell distribution width and the risk of heart events in patients with coronary artery disease. Exp Ther Med 2015; 9:1508-1514. [PMID: 25780460 PMCID: PMC4353804 DOI: 10.3892/etm.2015.2244] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 01/13/2015] [Indexed: 01/01/2023] Open
Abstract
Red cell distribution width (RDW) has been found to be a novel prognostic biomarker in patients with coronary artery disease (CAD); however, the association between RDW and the risk of heart events in patients with CAD is yet to be fully elucidated. Thus, the aim of the present study was to determine whether an elevated RDW was associated with the Framingham risk score (FRS) in patients with CAD. Data were retrospectively collected from Affiliated Dongyang Hospital of Wenzhou Medical University (Dongyang, China). The patients had undergone a coronary angiography and their clinical data were integrated. The patients (male, 260; female, 132) were divided into two groups based on the results of the coronary angiography, namely the CAD (n=283) and control groups (n=109). The FRS was calculated for all the subjects, and complete blood count testing with biochemical measurements was performed. The mean RDW level was 13.7±1.8% in the CAD group and 13.1±1.0% in the control group, while the mean FRS was 9.0±4.9 in the CAD group and 6.4±3.9 in the control group. The RDW and FRS were significantly higher in the CAD group compared with the control group (P<0.001). No statistically significant differences were observed between the groups with regard to the hematocrit, mean corpuscular volume, platelets, glucose, urea, albumin, aspartate aminotransferase, total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and N-terminal pro-brain natriuretic peptide (P>0.05). The RDW was shown to significantly correlate with the red blood cell (RBC) count (r=-0.133, P=0.029), hemoglobin level (r=-0.207, P=0.001) and TG level (r=0.226, P<0.001) within the laboratory parameters, as well as the FRS (r=0.206, P<0.001). In the stepwise multivariate linear regression, which included the RBC count, hemoglobin level, TG level and RDW, the FRS was predicted by hemoglobin (r2=0.034, P=0.001), TG (r2=0.059, P<0.001) and RDW (r2=0.030, P=0.003) parameters. Therefore, a novel association was revealed between higher levels of RDW and an elevated FRS in patients with CAD, which raises the possibility that a simple marker, RDW, may be associated with an increased risk of heart events in CAD patients.
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Affiliation(s)
- Weimin Li
- Department of Cardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang 322100, P.R. China
| | - Xiaoting Li
- Department of Cardiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310000, P.R. China
| | - Maofeng Wang
- Department of Clinical Laboratory Medicine, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang 322100, P.R. China
| | - Xuan Ge
- Department of Cardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang 322100, P.R. China
| | - Feixiang Li
- Department of Cardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang 322100, P.R. China
| | - Bian Huang
- Department of Cardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang 322100, P.R. China
| | - Jiren Peng
- Department of Cardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang 322100, P.R. China
| | - Guohong Li
- Department of Cardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang 322100, P.R. China
| | - Liang Lu
- Department of Cardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang 322100, P.R. China
| | - Zhuoyuan Yu
- Department of Cardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang 322100, P.R. China
| | - Jiaojiao Ma
- Department of Cardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang 322100, P.R. China
| | - Liaohang Xu
- Department of Cardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang 322100, P.R. China
| | - Meijuan Jin
- Department of Cardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang 322100, P.R. China
| | - Hongping Si
- Department of Cardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang 322100, P.R. China
| | - Rugen Wan
- Department of Clinical Laboratory Medicine, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang 322100, P.R. China
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Tenekecioglu E, Yilmaz M, Yontar OC, Bekler A, Peker T, Karaagac K, Ozluk OA, Agca FV, Kuzeytemiz M, Senturk M, Aslan B, Topal D. Red blood cell distribution width is associated with myocardial injury in non-ST-elevation acute coronary syndrome. Clinics (Sao Paulo) 2015; 70:18-23. [PMID: 25672424 PMCID: PMC4311120 DOI: 10.6061/clinics/2015(01)04] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 11/07/2014] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES The red blood cell distribution width has been associated with an increased risk of cardiovascular events. In the present study, we assessed the relationship between red cell distribution width values and cardiac troponin I levels in patients admitted with non-ST-elevation acute coronary syndrome. METHODS We analyzed blood parameters in 251 adult patients who were consecutively admitted to the intensive coronary care unit with non-ST-elevation acute coronary syndrome over a 1-year period. For all patients, a baseline blood sample was collected for routine hematological testing. Cardiac troponin I was measured at baseline and after 6 h. The patients were diagnosed with non-ST-elevation myocardial infarction or unstable angina based on the elevation of cardiac troponin I levels. RESULTS The red cell distribution width was higher in the group with non-ST-elevation myocardial infarction compared with the patient group with unstable angina (14.6±1.0 vs 13.06±1.7, respectively; p = 0.006). Coronary thrombus was detected more frequently in the group of patients with non-ST-elevation myocardial infarction than in the patients with unstable angina (72% vs 51%, respectively; p = 0.007). Using receiver operating characteristic curve analysis for the prediction of non-ST-elevation myocardial infarction based on the red cell distribution width, the area under the curve was 0.649 (95% confidence interval: 0.546-0.753; p = 0.006), suggesting a modest model for the prediction of non-ST-elevation myocardial infarction using the red cell distribution width. At a cut-off value of 14%, the sensitivity and specificity of the red cell distribution width were 73% and 59%, respectively. Additionally, the red cell distribution width was positively correlated with cardiac troponin I (r = 0.19; p = 0.006). CONCLUSION A greater baseline red cell distribution width value was associated with myocardial injury and elevated cardiac troponin I levels in non-ST-elevation acute coronary syndrome. Therefore, the red cell distribution width could be considered for risk stratification of acute coronary syndrome patients admitted to emergency departments.
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Affiliation(s)
| | - Mustafa Yilmaz
- Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - Osman Can Yontar
- Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - Adem Bekler
- Medicine School, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Tezcan Peker
- Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - Kemal Karaagac
- Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | | | | | | | - Muhammed Senturk
- Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - Burhan Aslan
- Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - Dursun Topal
- Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
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12
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Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci 2014; 52:86-105. [PMID: 25535770 DOI: 10.3109/10408363.2014.992064] [Citation(s) in RCA: 592] [Impact Index Per Article: 59.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The red blood cell distribution width (RDW) is a simple and inexpensive parameter, which reflects the degree of heterogeneity of erythrocyte volume (conventionally known as anisocytosis), and is traditionally used in laboratory hematology for differential diagnosis of anemias. Nonetheless, recent evidence attests that anisocytosis is commonplace in human disorders such as cardiovascular disease, venous thromboembolism, cancer, diabetes, community-acquired pneumonia, chronic obstructive pulmonary disease, liver and kidney failure, as well as in other acute or chronic conditions. Despite some demographic and analytical issues related to the routine assessment that may impair its clinical usefulness, an increased RDW has a high negative predictive value for diagnosing a variety of disorders, but also conveys important information for short- and long-term prognosis. Even more importantly, the value of RDW is now being regarded as a strong and independent risk factor for death in the general population. Although it has not been definitely established whether an increased value of RDW is a risk factor or should only be considered an epiphenomenon of an underlying biological and metabolic imbalance, it seems reasonable to suggest that the assessment of this parameter should be broadened far beyond the differential diagnosis of anemias. An increased RDW mirrors a profound deregulation of erythrocyte homeostasis involving both impaired erythropoiesis and abnormal red blood cell survival, which may be attributed to a variety of underlying metabolic abnormalities such as shortening of telomere length, oxidative stress, inflammation, poor nutritional status, dyslipidemia, hypertension, erythrocyte fragmentation and alteration of erythropoietin function. As such, the aim of this article is to provide general information about RDW and its routine assessment, to review the most relevant implications in health and disease and give some insights about its potential clinical applications.
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Affiliation(s)
- Gian Luca Salvagno
- Clinical Chemistry Section, Department of Life and Reproductive Sciences, Academic Hospital of Verona , Verona , Italy
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13
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Gromadziński L, Januszko-Giergielewicz B, Pruszczyk P. Red cell distribution width is an independent factor for left ventricular diastolic dysfunction in patients with chronic kidney disease. Clin Exp Nephrol 2014; 19:616-25. [PMID: 25248504 PMCID: PMC4543415 DOI: 10.1007/s10157-014-1033-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 09/15/2014] [Indexed: 01/14/2023]
Abstract
BACKGROUND The increased value of the red cell distribution width (RDW) was reported to indicate poor prognosis in patients with chronic heart failure. We evaluated the value of the RDW in the diagnosis of left ventricular diastolic dysfunction (LVDD) in patients without diastolic heart failure among the chronic kidney disease (CKD) population. METHODS The study group consisted of 73 ambulatory patients with CKD, stages 2-5. Standard echocardiography and tissue Doppler imaging (TDI) were performed, and the level of RDW was determined. Patients were divided into four groups according to the results of peak early diastolic velocity of mitral annulus (EmLV) and the stage of CKD: group with early stage CKD (eGFR > 30 ml/min/1.73 m(2)) without LVDD (EmLV ≥ 8 cm/s), early stage CKD with LVDD (EmLV < 8 cm/s), group with advanced stage CKD (eGFR ≤ 30 ml/min/1.73 m(2)) without LVDD, and group with advanced stage CKD with LVDD. RESULTS Patients with advanced stage CKD with LVDD were characterized by higher RDW levels than patients with advanced stage CKD without LVDD and with early stage CKD groups with and without LVDD [14.5 (13.8-19.5) % vs. 13.7 (11.4-15,4) %, p = 0.049, vs. 13.8(13.1-14.9) %, p = 0.031, vs. 13.7(12.1-16.2) %, p = 0.0007], respectively. The area under the receiver operating characteristic (ROC) curve of RDW level for the detection of LVDD was 0.649, 95 % confidence interval (CI) 0.528-0.758, p = 0.021, whereas ROC derived RDW value of >13.5 % was characterized by a sensitivity of 83.3 % and specificity of 45.2 % for predicting LVDD. The only independent factor of LVDD was RDW level >13.5 % with odds ratio (OR) = 3.92 (95 % CI 1.05-14.56), p = 0.037. CONCLUSION RDW can be used as an additional factor for the diagnosis of LVDD in patients with advanced stage of CKD.
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Affiliation(s)
- Leszek Gromadziński
- Department of Internal Diseases, Gastroenterology and Hepatology, University Clinical Hospital in Olsztyn, ul. Warszawska 30, 10-082, Olsztyn, Poland,
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Abdullahi H, Osman A, Rayis DA, Gasim GI, Imam AM, Adam I. Red blood cell distribution width is not correlated with preeclampsia among pregnant Sudanese women. Diagn Pathol 2014; 9:29. [PMID: 24499498 PMCID: PMC3916796 DOI: 10.1186/1746-1596-9-29] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 12/18/2013] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Preeclampsia is a leading cause of maternal and perinatal mortality worldwide. The exact etiology of preeclampsia is unknown, but the inflammatory process is postulated as one of the etiologies. Red blood cell distribution width (RDW) is a measure of anisocytosis (variation of red cell size) and is associated with hypertension and diabetic ketoacidosis. There are few data on the association between RDW and preeclampsia. This study aimed to investigate the association between RDW and preeclampsia. METHODS A case-control study was conducted at Khartoum Hospital, Sudan, during June to August 2012. Cases were women with preeclampsia and healthy women were controls. Sociodemographic characteristics, obstetrics, and clinical data were recorded. The complete blood count, including RDW, was measured using an automated hematology analyzer. RESULTS The cases and controls (65 women in each arm) were matched in their basic characteristics. There was no difference in the mean (SD) RDW between women with preeclampsia and controls (14.5 ± 1.8% vs. 14.4 ± 1.4%, P = 0.710). There was also no difference in the mean RDW between women with mild and severe preeclampsia (14.7 ± 1.9% vs. 13.9 ± 1.4%, P = 0.144. In logistic regression, there was no association between RDW and preeclampsia (OR = 0.9, CI = 0.7-1.1, P = 0.952). CONCLUSIONS RDW levels are not associated with the presence or severity of preeclampsia. VIRTUAL SLIDES The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1206247718115175.
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Affiliation(s)
| | | | | | | | | | - Ishag Adam
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
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15
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He W, Jia J, Chen J, Qin S, Tao H, Kong Q, Xue Q, Zhang D. Comparison of Prognostic Value of Red Cell Distribution Width and NT-proBNP for Short-Term Clinical Outcomes in Acute Heart Failure Patients. Int Heart J 2014; 55:58-64. [DOI: 10.1536/ihj.13-172] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Wenyan He
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University
| | - Jun Jia
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University
| | - Jia Chen
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University
| | - Shu Qin
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University
| | - Hongmei Tao
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University
| | - Qianran Kong
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University
| | - Qiu Xue
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University
| | - Dongying Zhang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University
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Kaya A, Isik T, Kaya Y, Enginyurt O, Gunaydin ZY, Iscanli MD, Kurt M, Tanboga IH. Relationship between red cell distribution width and stroke in patients with stable chronic heart failure: a propensity score matching analysis. Clin Appl Thromb Hemost 2013; 21:160-5. [PMID: 23804231 DOI: 10.1177/1076029613493658] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
AIM We aimed to investigate the association between baseline red cell distribution width (RDW) level and the risk of stroke in patients with heart failure (HF). METHODS A total of 153 consecutive patients with HF (New York Heart Association [NYHA] I-III and left ventricular ejection fraction of <40%) were included in this prospective study. All the patients were followed up for 1 year, and during this period the cerebrovascular disease was questioned. RESULTS In matched population, using propensity score matching comparing patients with HF having stroke with patients without stroke, we found significantly increased basal RDW and serum uric acid. The receiver-operating characteristic curves of RDW for predicting stroke are performed. An RDW ≥ 15.2% measured on admission had 87% sensitivity and 74% specificity in predicting stroke in patients with HF (area under the curve: 0.923, 95% confidence interval: 0.852-0.994, P < .001). CONCLUSION In conclusion, this study demonstrated that RDW may be important hematological indices for stroke in patients with HF using propensity score analysis.
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Affiliation(s)
- Ahmet Kaya
- Department of Cardiology, Ordu University Medical School, Ordu, Turkey
| | - Turgay Isik
- Department of Cardiology, Erzurum Education and Research Hospital, Erzurum, Turkey
| | - Yasemin Kaya
- Department of Internal Medicine, Ordu University Medical School, Ordu, Turkey
| | - Ozgur Enginyurt
- Department of Family Medicine, Ordu University Medical School, Ordu, Turkey
| | | | - Murat Dogan Iscanli
- Department of Emergency Medicine, Ministry of Health-Ordu University Education and Research Hospital, Ordu, Turkey
| | - Mustafa Kurt
- Department of Cardiology, Erzurum Education and Research Hospital, Erzurum, Turkey
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Kurt RK, Aras Z, Silfeler DB, Kunt C, Islimye M, Kosar O. Relationship of red cell distribution width with the presence and severity of preeclampsia. Clin Appl Thromb Hemost 2013; 21:128-31. [PMID: 23728834 DOI: 10.1177/1076029613490827] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
AIM Although the relationship between red cell distribution width (RDW) and hypertension has been well documented, there is an absence of data on the association between RDW and preeclampsia. In the present study, we have aimed to investigate the correlation of RDW with preeclampsia and its severity. METHODS The study population consisted of 52 (35 mild and 17 severe) patients with preeclampsia and 50 control pregnancy patients. For the entire study population, baseline RDW was measured using an automatic blood counter. RESULTS Although there were no significant differences between the preeclampsia group and the control group in terms of hemoglobin and platelet counts, the RDW (14.1 ± 1.1 vs 16.9 ± 1.7, P < .001), systolic and diastolic blood pressure, proteinuria, white blood cell, and high-sensitivity C-reactive protein levels were significantly higher in the preeclampsia group. Moreover, subgroup analysis revealed that RDW levels were significantly increased in patients with severe preeclampsia when compared to the patients with mild preeclampsia (18 ± 1.5 vs 16.4 ± 1.5, P < .001). CONCLUSION Our study results revealed that RDW levels were associated with both the presence and the severity of preeclampsia.
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Affiliation(s)
- Raziye Keskin Kurt
- Department of Obstetrics and Gynecology, Antakya State Hospital of Obstetrics and Child Care, Hatay, Turkey
| | - Zinnur Aras
- Department of Obstetrics and Gynecology, Antakya State Hospital of Obstetrics and Child Care, Hatay, Turkey
| | - Dilek Benk Silfeler
- Department of Obstetrics and Gynecology, Mustafa Kemal University Medical School, Hatay, Turkey
| | - Cigdem Kunt
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Mine Islimye
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Ozlem Kosar
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
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18
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The impact of admission red cell distribution width on the development of poor myocardial perfusion after primary percutaneous intervention. Atherosclerosis 2012; 224:143-9. [DOI: 10.1016/j.atherosclerosis.2012.06.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2012] [Revised: 05/30/2012] [Accepted: 06/06/2012] [Indexed: 12/13/2022]
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19
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Isik T, Kurt M, Ayhan E, Uyarel H, Tanboga IH, Korkmaz AF, Kaya A, Sevimli S. Relation of red cell distribution width with presence and severity of coronary artery ectasia. Clin Appl Thromb Hemost 2012; 18:441-7. [PMID: 22619398 DOI: 10.1177/1076029612447678] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Red cell distribution width (RDW) is an index that has been shown to be an independent correlate of adverse outcomes in some cardiac conditions. Isolated coronary artery ectasia (CAE) is an abnormality of the coronary anatomy and can cause ischemia. We hypothesized that increased RDW would be associated with isolated CAE because both are associated with inflammation. In this study, 2345 patients who received coronary angiography were retrospectively evaluated. After exclusion, 75 patients with isolated CAE and 96 consecutive patients with normal coronary were included in the study. The severity of isolated CAE was determined according to the Markis classification. Baseline RDW was measured as part of the automated complete blood count. Red cell distribution width was observed to be an independent predictor of both presence and severity of isolated CAE. In conclusion, RDW is associated with both the presence and severity of isolated CAE.
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Affiliation(s)
- Turgay Isik
- Department of Cardiology, Balikesir University, School of Medicine, Balıkesir, Turkey.
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20
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Hong N, Oh J, Kang SM, Kim SY, Won H, Youn JC, Park S, Jang Y, Chung N. Red blood cell distribution width predicts early mortality in patients with acute dyspnea. Clin Chim Acta 2012; 413:992-7. [PMID: 22406179 DOI: 10.1016/j.cca.2012.02.024] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Revised: 02/02/2012] [Accepted: 02/21/2012] [Indexed: 01/08/2023]
Abstract
BACKGROUND Red blood cell distribution width (RDW) has been shown to predict clinical outcomes in cardiovascular diseases. We studied whether RDW is useful to predict early mortality in patients with acute dyspnea at an emergency department (ED). METHODS We retrospectively analyzed 907 patients with acute dyspnea who visited the ED from January 2009 to May 2009. Primary outcome was 30-day mortality. RESULTS Acute decompensated heart failure (29.9%) was the most common adjudicated discharge diagnosis followed by cancer (14.8%) and pneumonia (12.5%). There was a stepwise increase of 30-day mortality risk from lowest (RDW<12.9%) to highest (RDW>14.3%) RDW tertiles (1.4% vs. 8.3% vs. 18.3%; log-rank P<0.001). In multivariate Cox hazard analysis, RDW was an independent predictor of 30-day mortality after adjusting for other risk factors (HR 1.23; 95% CI 1.11-1.36; P<0.001). Adding RDW to conventional clinical predictors significantly improved prediction for 30-day mortality as measured by the area under the ROC curve (AUC, from 0.873 to 0.885; P=0.023) and the net reclassification improvement (NRI=14.1%; P<0.001)/integrated discrimination improvement (IDI=0.038; P=0.006). CONCLUSIONS Our findings suggest that RDW measured at ED is an independent and additive predictor of early mortality in patients with acute dyspnea.
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Affiliation(s)
- Namki Hong
- Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Seoul, Republic of Korea
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Celik A, Koc F, Kadi H, Ceyhan K, Erkorkmaz U, Burucu T, Karayakali M, Onalan O. Relationship between red cell distribution width and echocardiographic parameters in patients with diastolic heart failure. Kaohsiung J Med Sci 2012; 28:165-72. [DOI: 10.1016/j.kjms.2011.06.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Accepted: 03/29/2011] [Indexed: 11/26/2022] Open
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Fonteque JH, Takahira RK, Saito ME, Valente ACDS, Barioni G, Kohayagawa A. Eritrograma, metabolismo do ferro e concentração sérica de eritropoetina em fêmeas caprinas da raça Saanen nos períodos de gestação, parto e pós-parto. PESQUISA VETERINÁRIA BRASILEIRA 2010. [DOI: 10.1590/s0100-736x2010001100014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
As alterações hematológicas durante o período de gestação, parto e pós-parto são de grande importância em humanos e têm sido estudadas em várias espécies de animais domésticos. O objetivo do trabalho foi determinar as alterações no eritrograma, no metabolismo do ferro e na concentração sérica de eritropoetina durante os períodos de gestação, parto e pós-parto em fêmeas nulíparas Saanen. Foram colhidas amostras de sangue de 20 fêmeas, clinicamente sadias, aos 49 (M1), 42 (M2), 35 (M3), 28 (M4), 21 (M5), 14 (M6), sete (M7), três (M8) dias antes do parto, no dia do parto (M9), três (M10) e sete (M11) dias após o parto, para a realização do eritrograma, proteína plasmática total, e dosagens séricas de eritropoetina, ferro, capacidade total de ligação do ferro, índice de saturação da transferrina e ferritina. Os dados foram analisados pelo teste de análise de variância (ANOVA) ao nível de 5% de significância (P<0,05). Houve diferença significativa (P<0,05) entre alguns momentos para as variáveis, número de eritrócitos, concentração de hemoglobina, volume globular, proteína total plasmática, concentração de ferro sérico, capacidade total de ligação do ferro (CLTF) e índice de saturação da transferrina (IST). Não houve diferença significativa (P<0,05) para as variáveis eritropoetina, volume corpuscular médio (VCM), hemoglobina corpuscular média (HCM), concentração de hemoglobina corpuscular média (CHCM), distribuição do diâmetro dos eritrócitos (DDE) e ferritina. Concluiu-se que não há aumento do estímulo para a produção de eritrócitos durante os períodos de gestação, parto e pós-parto em fêmeas Saanen e as alterações encontradas no eritrograma e no metabolismo do ferro não possuem significado clínico.
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Relation Between Red Cell Distribution Width With Echocardiographic Parameters in Patients With Acute Heart Failure. J Card Fail 2009; 15:517-22. [DOI: 10.1016/j.cardfail.2009.01.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2008] [Revised: 01/07/2009] [Accepted: 01/12/2009] [Indexed: 11/19/2022]
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Belo L, Rebelo I, Castro EMB, Catarino C, Pereira-Leite L, Quintanilha A, Santos-Silva A. Band 3 as a marker of erythrocyte changes in pregnancy. Eur J Haematol 2002; 69:145-51. [PMID: 12406007 DOI: 10.1034/j.1600-0609.2002.02788.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Modifications in the erythrocyte membrane protein band 3 seem to mark the cell for death. A decrease in band 3 high molecular weight aggregates (HMWAg) and a rise in its proteolytic fragments (Pfrag) were described for younger erythrocytes. The aim of this work was to study the band 3 profile as a marker of erythrocyte changes in pregnancy and postpartum. We performed a cross-sectional study in non-pregnant controls (n = 24), in women in the first (n = 64), second (n = 48) and third (n = 67) trimesters of gestation, and also in the puerperium (24-48 h after delivery; n = 32); we also carried out a longitudinal study (n = 23) during the three trimesters of normal pregnancy. We evaluated the band 3 profile (% of band 3 monomer, HMWAg, and Pfrag) and the membrane-bound haemoglobin. Total serum bilirrubin, glutathione peroxidase activity, red blood cell (RBC) count, haematocrit (Ht), haemoglobin (Hb) concentration, the haematimetric indices, and red cell distribution width were also evaluated. Similar results were found in pregnancy in both the cross-sectional and longitudinal studies. We found that the RBC count, Hb, and Ht decreased significantly in pregnancy and in puerperium. Band 3 profile in the first trimester of pregnancy, when compared with controls, presented significantly reduced HMWAg and increased Pfrag. Comparing the first with the third trimester, we found a significant reduction in band 3 and a significant rise in Pfrag. However, between these same periods, HMWAg did not decrease. Our data suggest band 3 profile as a marker of erythrocyte changes in pregnancy, which are independent of the 'physiological anaemia' of pregnancy. These changes suggest an increase in damaged RBCs, but also an increase in younger RBCs in the maternal circulation.
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Affiliation(s)
- Luís Belo
- Department of Biochemistry, Faculty of Pharmacy, University of Porto, Porto, Portugal.
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