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Heshmat-Ghahdarijani K, Fakhrolmobasheri M. Is Red Cell Distribution Width a Reliable Marker for Cardiovascular Diseases? A Narrative Review. Cardiol Rev 2024; 32:362-370. [PMID: 36730493 DOI: 10.1097/crd.0000000000000500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Red cell distribution width (RDW) is an easy-to-access marker which is routinely measured in complete blood count (CBC) test. Besides the classic use of RDW as a marker for discriminating different types of anemia, recent studies had indicated the relationship between high RDW and cardiovascular diseases. High RDW is not only useful in the diagnosis and prognostication of various cardiovascular conditions but also could be used as a valuable tool for predicting the incidence of cardiovascular diseases. population-based studies have indicated that higher RDW could effectively predict the incidence of heart failure (HF), atherosclerotic diseases, and atrial fibrillation (AF). It has been also demonstrated that higher RDW is associated with worse outcomes in these diseases. Recent studies have shown that high RDW is also associated with other cardiovascular conditions including cardiomyopathies, and pulmonary hypertension. The predictive role of RDW in endovascular interventions has also been demonstrated by many recent studies. Here in this review, we attempt to compile the most recent findings with older reports regarding the relation between high RDW and HF, cardiomyopathies, pulmonary hypertension, AF, atherosclerotic disorders, primary hypertension, and the outcomes of endovascular interventions. we also discussed the role of RDW in the prognostication of different cardiovascular conditions when combined with classic classification criteria.
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Affiliation(s)
- Kiyan Heshmat-Ghahdarijani
- From the Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Fakhrolmobasheri
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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McCalla G, Brown PD, Nwokocha C. Cadmium induces microcytosis and anisocytosis without anaemia in hypertensive rats. Biometals 2024; 37:519-526. [PMID: 38184813 DOI: 10.1007/s10534-023-00567-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/28/2023] [Indexed: 01/08/2024]
Abstract
Dietary cadmium (Cd2+) intake is implicated in the pathogenesis of hypertension and anaemia, but there is a paucity of information on the haematological changes in hypertensive conditions. This study, therefore, aims to evaluate the effects of Cd2+ on blood pressure (BP) and haematological indices in the Sprague-Dawley rat model. Three cohorts (n = 10 each) of control and Cd2+-fed male Sprague-Dawley rats were selected. Cd2+-exposed rats received 2.5 or 5 mg/kg b.w. cadmium chloride via gavage thrice-weekly for eight weeks, while control animals received tap water. BP and flow were measured non-invasively from rat tails twice-weekly using a CODA machine, while weights were measured thrice-weekly. Haematological indices were assessed using the Cell-Dyn Emerald Haematology Analyzer. Data were reported as mean ± SEM, and statistically analyzed using One-Way Analysis of Variance. Bonferroni post hoc test was used for multiple comparisons. Cd2+-exposure induced hypertension by significantly (p < 0.05) elevating systolic, diastolic, and mean arterial BPs, pulse pressure, and heart rate (HR), and increased (p < 0.05) blood flow. Mean cell volume (MCV) and haemoglobin (MCH) were significantly (p < 0.05) reduced, and red cell distribution width (RDW) significantly (p < 0.01) increased by exposure to 5 mg/kg b.w. Cd2+. Haemoglobin concentration (MCHC), haematocrit, haemoglobin, red blood cell, platelet, mean platelet volume, and white blood cell counts were unaffected by Cd2+-exposure. Cd2+ induced hypertension, microcytosis, hypochromicity, and anisocytosis without anaemia, which may be precursor to microcytic anaemia and coronary artery disease. This study is important in Cd2+-exposed environments and warrants further investigations.
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Affiliation(s)
- Garsha McCalla
- Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston 7, Jamaica.
| | - Paul D Brown
- Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston 7, Jamaica
| | - Chukwuemeka Nwokocha
- Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston 7, Jamaica
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Peng H, Su Y, Luo J, Ding N. Association between admission hemoglobin level and prognosis in sepsis patients based on a critical care database. Sci Rep 2024; 14:5212. [PMID: 38433267 PMCID: PMC10909867 DOI: 10.1038/s41598-024-55954-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 02/29/2024] [Indexed: 03/05/2024] Open
Abstract
This study aimed to explore the association between admission hemoglobin level and clinical outcomes in sepsis based on Medical Information Mart for Intensive Care IV(MIMIC-IV) database. It was a retrospective study. Sepsis patients in the database were included. Data extraction from MIMIC-IV was performed by PostgreSQL 9.6 software. Three different models including crude model (adjusted for none), model I (adjusted for gender and age) and model II (adjusted for all potential cofounders) were constructed. A generalized liner model and a smooth fitting curve for indicating the relationship between hemoglobin level and 30-day mortality were performed. 6249 septic patients with a 30.18% of 30-day mortality were included. With 1 g/dl increment in hemoglobin level, the values of odds ratio (OR) in crude model, model I and model II were 0.96 (95% confidential interval (CI) 0.94-0.99, P = 0.0023), 0.96 (95%CI 0.93-0.98, P = 0.0010) and 0.87 (95%CI 0.79-0.95, P = 0.0020), respectively. The smooth fitting curve indicated a non-linear relationship and the turning point was 7.2 g/dl. Compared the hemoglobin group < 7.2 g/dl, the risk of 30-day mortality significantly decreased by 32% in the hemoglobin group ≥ 7.2 g/dl (OR = 0.68, 95%CI 0.51-0.93, P = 0.0142). The non-linear relationship between admission hemoglobin level and 30-day mortality in sepsis was found. Hemoglobin supplementation might be beneficial for septic patients with hemoglobin level < 7.2 g/dl.
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Affiliation(s)
- Hongchun Peng
- Department of Orthopedics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China
| | - Yingjie Su
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, No. 161 Shaoshan South Road, Changsha, 410004, Hunan, China
| | - Ju Luo
- Department of Geriatrics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, No. 161 Shaoshan South Road, Changsha, 410004, Hunan, China.
| | - Ning Ding
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, No. 161 Shaoshan South Road, Changsha, 410004, Hunan, China.
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Zhou J, Ma W, Wan Y, Zhou Y, Wan W, Gu W, Li H, Xu C, Chen L. Predictive Value of the Hb/RDW Ratio for the Risk of All-Cause Death in Patients with Heart Failure with Different Ejection Fractions. Cardiology 2024; 149:237-247. [PMID: 38262371 DOI: 10.1159/000536440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 01/22/2024] [Indexed: 01/25/2024]
Abstract
INTRODUCTION The prognostic value of the ratio of haemoglobin to red cell distribution width (HRR) in different types of heart failure (HF) is not well known. METHOD AND RESULTS We analysed the long-term prognostic value of HRR in patients with HF using the Cox proportional risk model and Kaplan-Meier method. We reviewed consecutive 972 HF patients. The overall mortality rate was 45.68%. Mortality was 52.22% in the HFrEF group and 40.99% in the HFpEF + HFmrEF group. Cox regression showed that when HRR increased by 1 unit, the risk of all-cause death in all HF patients decreased by 22.8% (HR: 0.772, 95% CI: 0.724, 0.823, p < 0.001), in the HFpEF + HFmrEF group it decreased by 15.5% (HR: 0.845, 95% CI: 0.774, 0.923, p < 0.001), and in the HFrEF group it decreased by 36.1% (HR: 0.639, 95% CI: 0.576, 0.709, p < 0.0001). Subgroup analysis showed that there were interactions between the EF and HRR groups. The group in which HRR best predicted all-cause death from HF was group 1 (EF <40%, HRR <9.45), followed by group 2 (EF <40%, HRR ≥9.45), and group 3 (EF ≥40%, HRR <9.45). HRR had no predictive value in group 4 (EF ≥40%, HRR ≥9.45). CONCLUSION HRR is an important predictor of all-cause mortality in patients with HF, especially HFrEF. There is an interaction between HRR group and LVEF group.
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Affiliation(s)
- Jing Zhou
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wenfang Ma
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yu Wan
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yanji Zhou
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wen Wan
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wenyi Gu
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hongxia Li
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Chenggong Xu
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lixing Chen
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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Chen H, Zhen Z, Dong Y, Liu C, Dong B, Xue R. Hemoglobin to red cell distribution width ratio: A predictor of clinical outcome and diuretic response in patients with acute heart failure. Int J Cardiol 2024; 394:131368. [PMID: 37739043 DOI: 10.1016/j.ijcard.2023.131368] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Hemoglobin to Red Cell Distribution Width Ratio (HRR) is a novel inflammatory marker in the prognostic assessment of tumors. Nevertheless, its focus on the cardiovascular field is relatively limited, particularly regarding its correlation with diuretic responses and clinical outcomes. METHODS This is a secondary analysis of the Renal Optimization Strategies Evaluation (ROSE AHF) clinical trial. The outcomes of interest included all-cause death, rehospitalization and diuretic responses. Multivariable Cox proportional hazard regression and linear regression models were performed, respectively. Prognostic outcomes and diuretic response were further evaluated in ejection fraction (EF) subgroups (preserved EF ≥ 50% and reduced EF<50%). RESULTS A total of 351 patients were included in the present study and further categorized according to HRR median (0.7131) value at admission: low HRR group (n = 176) and high HRR group (n = 175). High HRR were found to be independently associated with decreased risk of all-cause death (HR = 0.51; 95% CI,0.30-0.87, P = 0.013), reduced risk of developing all-caused death or rehospitalization (HR = 0.62; 95% CI,0.39-0.98, P = 0.039). Furthermore, high HRR indicated lower cumulative urine output (OR: -992.33, P = 0.004) and less weight loss (OR: 3.08, P < 0.001) within 72 h after diuresis. Subgroup analysis revealed no significant interaction effect between EF and HRR in prognostic impact or diuretic responses, and HRR was negatively correlated with plasma volume. CONCLUSION High HRR demonstrated a lower risk of developing adverse clinical outcomes and a poorer diuretic response that might be due to less volume overload in AHF patients.
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Affiliation(s)
- Hao Chen
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, PR China; NHC Key Laboratory of Assisted Circulation and Vascular Diseases, Sun Yat-sen University, Guangzhou 510080, PR China; National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou 510080, PR China
| | - Zhe Zhen
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, PR China; NHC Key Laboratory of Assisted Circulation and Vascular Diseases, Sun Yat-sen University, Guangzhou 510080, PR China; National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou 510080, PR China
| | - Yugang Dong
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, PR China; NHC Key Laboratory of Assisted Circulation and Vascular Diseases, Sun Yat-sen University, Guangzhou 510080, PR China; National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou 510080, PR China
| | - Chen Liu
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, PR China; NHC Key Laboratory of Assisted Circulation and Vascular Diseases, Sun Yat-sen University, Guangzhou 510080, PR China; National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou 510080, PR China
| | - Bin Dong
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, PR China; NHC Key Laboratory of Assisted Circulation and Vascular Diseases, Sun Yat-sen University, Guangzhou 510080, PR China; National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou 510080, PR China.
| | - Ruicong Xue
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, PR China; NHC Key Laboratory of Assisted Circulation and Vascular Diseases, Sun Yat-sen University, Guangzhou 510080, PR China; National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou 510080, PR China.
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Coradduzza D, Medici S, Chessa C, Zinellu A, Madonia M, Angius A, Carru C, De Miglio MR. Assessing the Predictive Power of the Hemoglobin/Red Cell Distribution Width Ratio in Cancer: A Systematic Review and Future Directions. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2124. [PMID: 38138227 PMCID: PMC10744746 DOI: 10.3390/medicina59122124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/20/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: The hemoglobin (Hb)/red cell distribution width (RDW) ratio has emerged as an accessible, repeatable, and inexpensive prognostic factor that may predict survival in cancer patients. The focus of this systematic review is to investigate the prognostic role of the Hb/RDW ratio in cancer and the implications for clinical practice. Materials and Methods: A literature search of PubMed, Scopus, and Web of Science databases was performed by an independent author between 18 March and 30 March 2023 to collect relevant literature that assessed the prognostic value of the Hb/RDW ratio in cancer. Overall survival (OS), progression-free survival (PFS), and the association of these with the Hb/RDW ratio were considered to be the main endpoints. Results: Thirteen retrospective studies, including 3818 cancer patients, were identified and involved in this review. It was observed that, when patients with a high vs. low Hb/RDW ratio were compared, those with a lower Hb/RDW ratio had significantly poorer outcomes (p < 0.05). In lung cancer patients, a one-unit increase in the Hb/RDW ratio reduces mortality by 1.6 times, whilst in esophageal squamous-cell carcinoma patients, a lower Hb/RDW ratio results in a 1.416-times greater risk of mortality. Conclusions: A low Hb/RDW ratio was associated with poor OS and disease progression in patients with cancer. This blood parameter should be considered a standard biomarker in clinical practice for predicting OS and PFS in cancer patients. Future searches will be necessary to determine and standardize the Hb/RDW cut-off value and to assess whether the Hb/RDW ratio is optimal as an independent prognostic factor or if it requires incorporation into risk assessment models for predicting outcomes in cancer patients.
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Affiliation(s)
- Donatella Coradduzza
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (D.C.); (A.Z.)
| | - Serenella Medici
- Department of Chemical, Physical, Mathematical and Natural Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Carla Chessa
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (C.C.); (M.M.)
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (D.C.); (A.Z.)
| | - Massimo Madonia
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (C.C.); (M.M.)
| | - Andrea Angius
- Istituto di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale delle Ricerche (CNR), Cittadella Universitaria di Cagliari, 09042 Cagliari, Italy;
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (D.C.); (A.Z.)
- Control Quality Unit, Azienda-Ospedaliera Universitaria (AOU), 07100 Sassari, Italy
| | - Maria Rosaria De Miglio
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (C.C.); (M.M.)
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Zheng Y, Wu T, Hou X, Yang H, Yang Y, Xiu W, Pan Y, Ma Y, Mahemuti A, Xie X. Serum a-1 antitrypsin as a novel biomarker in chronic heart failure. ESC Heart Fail 2023; 10:2865-2874. [PMID: 37417425 PMCID: PMC10567649 DOI: 10.1002/ehf2.14451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 04/11/2023] [Accepted: 06/21/2023] [Indexed: 07/08/2023] Open
Abstract
AIMS Chronic heart failure (CHF) remains a major health issue worldwide. In the present study, we aimed to identify novel circulating biomarkers for CHF using serum proteomics technology and to validate the biomarker in three independent cohorts. METHODS AND RESULTS The isobaric tags for relative and absolute quantitation technology was utilized to identify the potential biomarkers of CHF. The validation was conducted in three independent cohort. Cohort A included 223 patients with ischaemic heart disease (IHD) and 321 patients with ischaemic heart failure (IHF) from the CORFCHD-PCI study. Cohort B recruited 817 patients with IHD and 1139 patients with IHF from the PRACTICE study. Cohort C enrolled 559 non-ischaemic heart disease patients with CHF (n = 316) or without CHF (n = 243). We found the expression of a-1 antitrypsin (AAT) was elevated significantly in patients with CHF compared with that in the patients with stable IHD using statistical and bioinformatics analyses. In a validation study, there was a significant difference between patients with stable IHD and patients with IHF in AAT concentration either in cohort A (1.35 ± 0.40 vs. 1.64 ± 0.56, P < 0.001) or in cohort B (1.37 ± 0.42 vs. 1.70 ± 0.48, P < 0.001). The area under the receiver operating characteristic curve was 0.70 [95% confidence interval (CI): 0.66 to 0.74, P < 0.001] in cohort A and 0.74 (95% CI: 0.72 to 0.76, P < 0.001) in cohort B. Furthermore, AAT was negative correlated with left ventricular ejection fraction (r = -0.261, P < 0.001). After adjusting for confounders using a multivariate logistic regression analysis, AAT remained an independent association with CHF in both cohort A (OR = 3.14, 95% CI: 1.667 to 5.90, P < 0.001) and cohort B (OR = 4.10, 95% CI: 2.97 to 5.65, P < 0.001). This association was also validated in cohort C (OR = 1.86, 95% CI: 1.02 to 3.38, P = 0.043). CONCLUSIONS The present study suggests that serum AAT is a reliable biomarker for CHF in a Chinese population.
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Affiliation(s)
- Ying‐Ying Zheng
- Department of CardiologyFirst Affiliated Hospital of Xinjiang Medical UniversityNo. 137, Liyushan RoadUrumqi830011XinjiangChina
| | - Ting‐Ting Wu
- Department of CardiologyFirst Affiliated Hospital of Xinjiang Medical UniversityNo. 137, Liyushan RoadUrumqi830011XinjiangChina
| | - Xian‐Geng Hou
- Department of CardiologyFirst Affiliated Hospital of Xinjiang Medical UniversityNo. 137, Liyushan RoadUrumqi830011XinjiangChina
| | - Hai‐Tao Yang
- Department of CardiologyFirst Affiliated Hospital of Xinjiang Medical UniversityNo. 137, Liyushan RoadUrumqi830011XinjiangChina
| | - Yi Yang
- Department of CardiologyFirst Affiliated Hospital of Xinjiang Medical UniversityNo. 137, Liyushan RoadUrumqi830011XinjiangChina
| | - Wen‐Juan Xiu
- Department of CardiologyFirst Affiliated Hospital of Xinjiang Medical UniversityNo. 137, Liyushan RoadUrumqi830011XinjiangChina
| | - Ying Pan
- Department of CardiologyFirst Affiliated Hospital of Xinjiang Medical UniversityNo. 137, Liyushan RoadUrumqi830011XinjiangChina
| | - Yi‐Tong Ma
- Department of CardiologyFirst Affiliated Hospital of Xinjiang Medical UniversityNo. 137, Liyushan RoadUrumqi830011XinjiangChina
| | - Ailiman Mahemuti
- Department of CardiologyFirst Affiliated Hospital of Xinjiang Medical UniversityNo. 137, Liyushan RoadUrumqi830011XinjiangChina
| | - Xiang Xie
- Department of CardiologyFirst Affiliated Hospital of Xinjiang Medical UniversityNo. 137, Liyushan RoadUrumqi830011XinjiangChina
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Yazdani AN, Pletsch M, Chorbajian A, Zitser D, Rai V, Agrawal DK. Biomarkers to monitor the prognosis, disease severity, and treatment efficacy in coronary artery disease. Expert Rev Cardiovasc Ther 2023; 21:675-692. [PMID: 37772751 PMCID: PMC10615890 DOI: 10.1080/14779072.2023.2264779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/26/2023] [Indexed: 09/30/2023]
Abstract
INTRODUCTION Coronary Artery Disease (CAD) is a prevalent condition characterized by the presence of atherosclerotic plaques in the coronary arteries of the heart. The global burden of CAD has increased significantly over the years, resulting in millions of deaths annually and making it the leading health-care expenditure and cause of mortality in developed countries. The lack of cost-effective strategies for monitoring the prognosis of CAD warrants a pressing need for accurate and efficient markers to assess disease severity and progression for both reducing health-care costs and improving patient outcomes. AREA COVERED To effectively monitor CAD, prognostic biomarkers and imaging techniques play a vital role in risk-stratified patients during acute treatment and over time. However, with over 1,000 potential markers of interest, it is crucial to identify the key markers with substantial utility in monitoring CAD progression and evaluating therapeutic interventions. This review focuses on identifying and highlighting the most relevant markers for monitoring CAD prognosis and disease severity. We searched for relevant literature using PubMed and Google Scholar. EXPERT OPINION By utilizing the markers discussed, health-care providers can improve patient care, optimize treatment plans, and ultimately reduce health-care costs associated with CAD management.
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Affiliation(s)
- Armand N. Yazdani
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766
| | - Michaela Pletsch
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766
| | - Abraham Chorbajian
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766
| | - David Zitser
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766
| | - Vikrant Rai
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766
| | - Devendra K. Agrawal
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766
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Liu J, Wang J. Association between hemoglobin-to-red blood cell distribution width ratio and hospital mortality in patients with non-traumatic subarachnoid hemorrhage. Front Neurol 2023; 14:1180912. [PMID: 37388548 PMCID: PMC10303799 DOI: 10.3389/fneur.2023.1180912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/24/2023] [Indexed: 07/01/2023] Open
Abstract
Background In patients with ischemic stroke, low hemoglobin-to-red blood cell distribution width ratio (HRR) was associated with an increased risk of mortality. However, it was unknown in the non-traumatic subarachnoid hemorrhage (SAH) population. The purpose of this study was to examine the association between baseline HRR and in-hospital mortality in patients with non-traumatic SAH. Methods Non-traumatic SAH patients were screened out of the Medical Information Mart for Intensive IV (MIMIC-IV) database between 2008 and 2019. The Cox proportional hazard regression models were utilized to analyze the association between baseline HRR and in-hospital mortality. Restricted cubic splines (RCS) analysis was utilized to determine the relationship curve between hospital mortality and the HRR level and examine the threshold saturation effect. We further applied Kaplan-Meier survival curve analysis to examine the consistency of these correlations. The interaction test was used to identify subgroups with differences. Results A total of 842 patients were included in this retrospective cohort study. Compared with individuals with lower HRR Q1 ( ≤ 7.85), the adjusted HR values in Q2 (7.86-9.15), Q3 (9.16-10.16), and Q4 (≥10.17) were 0.574 (95% CI: 0.368-0.896, p = 0.015), 0.555 (95% CI: 0.346-0.890, p = 0.016), and 0.625 (95% CI: 0.394-0.991, p = 0.045), respectively. The association between the HRR level and in-hospital mortality exhibited a non-linear relationship (p < 0.05). The threshold inflection point value of 9.50 was calculated using RCS analysis. When the HHR level was lower than 9.50, the risk of in-hospital mortality rate decreased with an adjusted HR of 0.79 (95% CI: 0.70-0.90, p = 0.0003). When the HRR level was higher than 9.50, the risk of in-hospital mortality almost hardly increased with the increase in the HRR level (adjusted HR = 1.18, 95% CI: 0.91-1.53, p = 0.2158). K-M analysis showed that patients with low HRR levels had significantly higher in-hospital mortality (p < 0.001). Conclusion There was a non-linear connection between the baseline HRR level and in-hospital mortality. A low level of HRR could increase the risk of death in participants with non-traumatic SAH.
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Affiliation(s)
- Jiuling Liu
- Department of Neurology, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, China
| | - Junhong Wang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Yildiz D, Cakir U, Tugcu AU, Ceran B, Tayman C. Hemoglobin/Red Cell Distribution width Ratio (HRR): A Novel and Promising Red Cell Parameter in Ductal Closure. Arq Bras Cardiol 2023; 120:e20220339. [PMID: 36856242 PMCID: PMC10263456 DOI: 10.36660/abc.20220339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/23/2022] [Accepted: 11/16/2022] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND It is still unclear how effective hematological parameters are in the closure of patent ductus arteriosus (PDA). OBJECTIVES The primary aim of our study is to investigate the effect of hemoglobin (HB)-to-red cell distribution width (RDW) ratio (HRR) on the closure of PDA. METHODS Premature babies with very low birth weight (VLBW: <1500 g) and <32 gestational weeks were included in the study, and all data were recorded retrospectively. Demographic characteristics, clinical results, red cell parameters, and HRR and their ratios were compared between hemodynamically significant PDA (hsPDA) and non-hsPDA groups. All results were statically analyzed, and P<0.05 was considered statistically significant. RESULTS A total of 677 premature babies, 269 in the hsPDA group and 408 in the non-hsPDA group, were included in the study. Hemoglobin (HB), hematocrit (HCT), mean cell volume (MCV), red blood cell (RBC), red cell distribution width (RDW), mean platelet volume (MPV), MCV/RBC ratio, HB/RBC ratio, RDW/RBC ratio, and RDW/MPV ratio were found to be similar between hsPDA and non-hsPDA groups, (p>0.05). HRR was found to be significantly lower in the hsPDA group [median (Quartile 1 (Q1) - Q3) (Q1 - Q3): 0.93 (0.8-1.0)] compared to non-hsPDA [median ( Q1 - Q3): 1.07 (1.0-1.2)] (p<0.001). The AUC for the diagnostic value of HRR in hsPDA was 0.816, and the cutoff value was ≤0.98 (p<0.001, 95% [CI]: 0.785-0.845, sensitivity: 90%, specificity: 92%). CONCLUSIONS HRR value was found to be both an effective and powerful parameter in diagnosing hsPDA.
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Affiliation(s)
- Duran Yildiz
- Divisão de NeonatologiaDepartamento de PediatriaUniversidade de Ciências da SaúdeAnkaraTurkeyAnkara Bilkent City Hospital – Divisão de Neonatologia – Departamento de Pediatria – Universidade de Ciências da Saúde, Ankara – Turkey
| | - Ufuk Cakir
- Divisão de NeonatologiaDepartamento de PediatriaUniversidade de Ciências da SaúdeAnkaraTurkeyAnkara Bilkent City Hospital – Divisão de Neonatologia – Departamento de Pediatria – Universidade de Ciências da Saúde, Ankara – Turkey
| | - Ali Ulaş Tugcu
- Divisão de NeonatologiaDepartamento de PediatriaUniversidade de Ciências da SaúdeAnkaraTurkeyAnkara Bilkent City Hospital – Divisão de Neonatologia – Departamento de Pediatria – Universidade de Ciências da Saúde, Ankara – Turkey
| | - Burak Ceran
- Divisão de NeonatologiaDepartamento de PediatriaUniversidade de Ciências da SaúdeAnkaraTurkeyAnkara Bilkent City Hospital – Divisão de Neonatologia – Departamento de Pediatria – Universidade de Ciências da Saúde, Ankara – Turkey
| | - Cuneyt Tayman
- Divisão de NeonatologiaDepartamento de PediatriaUniversidade de Ciências da SaúdeAnkaraTurkeyAnkara Bilkent City Hospital – Divisão de Neonatologia – Departamento de Pediatria – Universidade de Ciências da Saúde, Ankara – Turkey
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Relationship between the Hemoglobin-to-Red Cell Distribution Width Ratio and All-Cause Mortality in Septic Patients with Atrial Fibrillation: Based on Propensity Score Matching Method. J Cardiovasc Dev Dis 2022; 9:jcdd9110400. [PMID: 36421935 PMCID: PMC9696521 DOI: 10.3390/jcdd9110400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/06/2022] [Accepted: 11/17/2022] [Indexed: 11/19/2022] Open
Abstract
(1) Objective: To reveal the correlation between the hemoglobin-to-red cell distribution width ratio (HRR) and all-cause mortality (ACM) among the septic patients with atrial fibrillation. (2) Methods: Specific clinical information was collected from the Medical Information Mart for Intensive IV (MIMIC-IV) database. The optimal cut-off value of HRR was calculated through ROC curve analysis conducted by using the maximum Youden index for the prediction of survival status. In addition, univariable and multivariable Cox regressive analyses were carried out to assess the prognostic significance of HRR and the Kaplan-Meier (K-M) analysis was conducted to draw the survival curves. Then, the 1:1 propensity score matching (PSM) method was adopted to improve the reliability of research result while balancing the unintended influence of underlying confounders. (3) Results: There were 9228 patients participating in this retrospective cohort study. The optimal cut-off value of the HRR was determined as 5.877 for in-hospital mortality. The PSM was performed to identify 2931 pairs of score-matched patients, with balanced differences exhibited by nearly all variables. According to the K-M analysis, those patients with a lower HRR than 5.877 showed a significantly higher level of in-hospital mortality, 28-day mortality, and 90-day mortality, compared to the patients with HRR ≥ 5.877 (p < 0.001). After the adjustment of possible confounders, those patients whose HRR was below 5.877 had a significantly higher level of in-hospital mortality than the patients with HRR ≥ 5.877, as revealed by the multivariable Cox regression analysis (HR = 1.142, 95%CI: 1.210−1.648, p < 0.001). Similarly, the ACM remained substantially higher in those patients with a lower HRR than in the patients with higher HRR after PSM. (4) Conclusion: A lower HRR (<5.877) was evidently associated with an increased risk of ACM, which made it applicable as a prognostic predictor of clinical outcomes for those septic patients with atrial fibrillation.
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Huang X, Yuan S, Ling Y, Tan S, Huang T, Cheng H, Lyu J. The Hemoglobin-to-Red Cell Distribution Width Ratio to Predict All-Cause Mortality in Patients with Sepsis-Associated Encephalopathy in the MIMIC-IV Database. Int J Clin Pract 2022; 2022:7141216. [PMID: 36683597 PMCID: PMC9825232 DOI: 10.1155/2022/7141216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE The hemoglobin-to-red cell distribution width ratio (HRR) is associated with the prognosis of sepsis-associated encephalopathy (SAE). This study aimed to determine the relationship between HRR and SAE and to clarify the possible mechanism of HRR as a prognostic factor for SAE. METHODS A multivariate Cox proportional-hazards regression model was used to assess the correlation between HRR and all-cause mortality. Piecewise linear regression and smooth-curve Cox proportional-hazards regression models were used to observe whether there was a nonlinear relationship between HRR and all-cause mortality in SAE. RESULTS This study included 8853 patients with SAE. A nonlinear relationship between HRR and SAE was observed through a two-segment regression model. The left inflection point for the HRR threshold was calculated to be 15.54, which was negatively correlated with all-cause mortality (HR = 0.83, 95% CI = 0.76-0.91, p < 0.001). Subgroup analyses revealed significant interactions between white blood cell count, glucose, and patients who received dialysis and HRR. The inverse correlation between HRR and SAE was more pronounced in patients who did not receive vasopressin (HR = 0.91, 95% CI = 0.87-0.96, p < 0.001) than in those who did receive vasopressin (HR = 0.94, 95% CI = 0.88-1.02, p=0.152) and was significantly more pronounced in patients without myocardial infarction (HR = 0.91, 95% CI = 0.88-0.96, p < 0.001) than in those with myocardial infarction (HR = 0.94, 95% CI = 0.87-1.02, p < 0.114). CONCLUSION This large retrospective study found a nonlinear relationship between all-cause mortality and HRR in patients with SAE in intensive care units, with low HRR being inversely associated with increased all-cause mortality in patients with SAE.
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Affiliation(s)
- Xiaxuan Huang
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shiqi Yuan
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yitong Ling
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shanyuan Tan
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Tao Huang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hongtao Cheng
- School of Nursing, Jinan University, Guangzhou 510630, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
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