1
|
Jian W, Shen X, Zheng Z, Wu Z, Shi Y, Liu J. Association Between Red Blood Cell Distribution Width and Coronary Calcification in Patients Referred for Invasive Coronary Angiography. Angiology 2024:33197241238509. [PMID: 38468156 DOI: 10.1177/00033197241238509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
This study aimed to determine whether red cell distribution width (RDW) is associated with coronary calcification. A total of 4796 patients who underwent coronary computed tomography angiography and subsequent invasive coronary angiography were consecutively enrolled. Coronary artery calcium score (CACS), demographic, clinical, and laboratory data were collected from electronic medical records. RDW were expressed in two forms, as a coefficient of variation (CV) or as a standard deviation (SD). Multivariable ordinal logistic regression was used to investigate the association of RDW with CACS grades (CACS 0-99, 100-399, 400-999, and >1000). A significant association was found between elevated RDW-SD and higher CACS grades after full adjustment (adjusted OR per 1-SD increase: 1.11, 95% CI: 1.05-1.18; P < .001), while no significant association was found between RDW-CV and CACS grades. When RDW-SD was analyzed as a categorical variable, it was primarily the 4th quartile of RDW-SD that was associated with elevated CACS grades compared with the 1st quartile (adjusted OR: 1.25, 95% CI: 1.07-1.46; P = .006), while the 2nd and 3rd quartiles showed no significantly higher risk. RDW-SD is a more robust biomarker for coronary calcification compared with RDW-CV.
Collapse
Affiliation(s)
- Wen Jian
- Center for Coronary Artery Disease, Beijing Anzhen Hospital of Capital Medical University, Beijing, China
| | - Xueqian Shen
- Center for Coronary Artery Disease, Beijing Anzhen Hospital of Capital Medical University, Beijing, China
| | - Ze Zheng
- Center for Coronary Artery Disease, Beijing Anzhen Hospital of Capital Medical University, Beijing, China
| | - Zheng Wu
- Center for Coronary Artery Disease, Beijing Anzhen Hospital of Capital Medical University, Beijing, China
| | - Yuchen Shi
- Center for Coronary Artery Disease, Beijing Anzhen Hospital of Capital Medical University, Beijing, China
| | - Jinghua Liu
- Center for Coronary Artery Disease, Beijing Anzhen Hospital of Capital Medical University, Beijing, China
| |
Collapse
|
2
|
Naghedi A, Varastehravan H, Haghaninejad H, Naghedi A, Farshadi N. Importance of so called "novel cardiovascular risk factors" in severity of coronary artery calcification; how serious they should be taken: a systematic review and metaanalysis. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2023; 93:212-222. [PMID: 36634706 PMCID: PMC10161817 DOI: 10.24875/acm.210004061] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 06/21/2022] [Indexed: 01/14/2023] Open
Abstract
Cardiovascular diseases are among important causes of death. Atherosclerosis is an important etiology for coronary artery diseases in which coronary artery calcification plays a principal role. Recently novel cardiovascular risk factors in coronary calcification are under attention. In this study, we investigated possible association between novel cardiovascular risk factors and coronary calcification. This is a prospectively registered systematic review and meta-analysis in PROSPERO and was performed in accordance with PRISMA guidelines. Medical databases were searched. Primary papers were screened and studies reporting our outcomes of interest were selected for data extraction. Quantitative data syntheses were performed using Comprehensive Meta-analysis Ver.3. In this study, 5252 papers were screened and finally 28 papers including 31241 patients underwent data extraction. Based on our findings, neutrophil/lymphocyte ratio (8 out of 10), red cell distribution width (r = 0.250, p < 0.0001), and interleukin 6 (odds ratio [OR]: 1.101 [95% confidence interval (CI): 1.001-1.210], p = 0.047) were associated with severity of coronary calcification while C-reactive protein (one out of eight) was not associated with coronary calcification. Results of lymphocyte/monocyte ratio (r = -0.120, p < 0.001), platelet/lymphocyte ratio (OR: 1.47 [95% CI: 0.89-2.41, p = 0.124]), and MPV (r = 0.017, p = 0.814 vs. OR: 1.91 [95% CI: 1.28-2.85, p = 0.002]) remained controversial due to few number of included studies or contrary results. We can conclude that neutrophil/lymphocyte ratio, red cell distribution width, and interleukin-6 are significantly associated with coronary calcification and C-reactive protein is not significantly associated with severity of coronary calcification. Our results about mean platelet volume, platelet/lymphocyte ratio, and lymphocyte/monocyte ratio are not reliable and require further investigations.
Collapse
Affiliation(s)
- Aryan Naghedi
- Faculty of Medicine, Shahid Sadoughi University of Medical Sciences
| | - Hamidreza Varastehravan
- Department of Cardiology, Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences
| | - Hasan Haghaninejad
- Department of Cardiology, Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences
| | - Arvin Naghedi
- Department of Mathematics, Yazd University. Yazd, Iran
| | - Nima Farshadi
- Faculty of Medicine, Shahid Sadoughi University of Medical Sciences
| |
Collapse
|
3
|
Jin F, Chang X, Wang X, Xiong H, Wang L, Zhang B, Wang P, Zhao L. Relationship between red blood cell-related indices and coronary artery calcification. Postgrad Med J 2023; 99:4-10. [PMID: 36947423 DOI: 10.1093/postmj/qgac003] [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: 11/02/2021] [Revised: 09/18/2022] [Accepted: 09/25/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Red blood cell (RBC) indices such as RBC count and RBC distribution width (RDW) are associated with heart failure and coronary artery disease, but the relationship between RBC indices and coronary artery calcification (CAC) is unclear. This study aimed to investigate RBC indices' correlation with, and predictive value for, the presence and severity of CAC. METHODS In this study, 1257 hospitalized patients who received a coronary computed tomography angiography examination were finally selected. Patients were classified into a control group (without CAC, n = 655) and a calcification group (with CAC, n = 602) according to their CAC score. The calcification group was further divided into a low calcification group, medium calcification group, and high calcification group. RESULTS In the calcification group, the RBC count was lower, and the RDW-standard deviation (SD) and RDW-coefficient of variation (CV) were higher, than those in the control group (P < .05). In the high calcification group, the RBC count was significantly lower, and the RDW-SD and RDW-CV were significantly higher, than those in the low calcification group (P < .05). Multivariate logistic regression analysis showed that RBC count, RDW-SD, and RDW-CV were independent predictors of CAC presence. Furthermore, multivariate logistic regression analysis also showed that RBC count and RDW-SD were independent predictors of severe CAC. CONCLUSIONS RBC indices were significantly associated with the presence and severity of CAC, indicating that these RBC indices have the potential to be predictors of CAC.
Collapse
Affiliation(s)
- Fulu Jin
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Xiansong Chang
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
- Emergency Department of Xuguan District, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Xiaozhong Wang
- Emergency Department of Xuguan District, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Hui Xiong
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
- Emergency Department of Xuguan District, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Li Wang
- Emergency Department of Xuguan District, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Bo Zhang
- Radiology Department, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004 China
| | - Peiyu Wang
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Liangping Zhao
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| |
Collapse
|
4
|
Yamamoto T, Endo D, Shimada A, Matsushita S, Asai T, Amano A. Surgical treatment of acute aortic dissection in a patient with SLE and prior antiphospholipid syndrome on therapy for over 30 years: a case report. BMC Cardiovasc Disord 2022; 22:216. [PMID: 35562652 PMCID: PMC9103044 DOI: 10.1186/s12872-022-02659-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 05/02/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In patients with systemic lupus erythematosus (SLE), lengthy treatment and long-term steroid use are the main risk factors for developing aortic aneurysms or aortic dissections. In patients with cardiac tamponade, hemodynamic collapse may lead to acute renal and hepatic failure. CASE PRESENTATION We report the successful treatment of a 55-year-old woman with SLE since the age of 21. She suddenly felt chest pain approximately 2 weeks before developing fever and vomiting and was admitted to our hospital. Initially, she had severe liver dysfunction and was admitted to the hepatology department, where treatment for fulminant hepatitis was initiated. However, computed tomography (CT) showed an acute aortic dissection (DeBakey type II) and severe bloody pericardial effusion. Therefore, we performed emergency pericardial drainage. Plasma exchange therapy was initiated as emergency aortic surgery was deemed impossible due to impaired liver function tests and coagulation. Ten days later, the patient developed peritonitis due to small bowel perforation, and laparotomy was performed for abscess drainage and perforation closure. She had received steroid pulse therapy at the age of 21. At 40 years of age, she developed deep vein thrombosis due to antiphospholipid antibodies and was prescribed prednisolone. She was ambulatory at 3 months after the onset of acute aortic dissection, and CT revealed a rapidly enlarging true aneurysm in the distal arch. We performed elective aortic surgery. Although there were no antiphospholipid antibodies, surgery could have led to a devastating antiphospholipid syndrome. Therefore, we decided to treat the patient with triple therapy. Methylprednisolone was intravenously administered intraoperatively and at 1 day postoperatively. The patient was discharged without complications after returning to her usual oral prednisolone regimen. CONCLUSIONS The patient described herein had a systemic circulatory failure due to cardiac tamponade, accompanied by liver failure. This condition is a significant cause of death in patients with aortic dissection-associated SLE and is extremely dangerous. However, multi-specialty intervention helped the patient recover, and she has been attending the outpatient clinic. Aortic surgery requiring hypothermia in SLE patients with antiphospholipid syndrome and a history of thrombocytopenia or thrombosis requires a multi-disciplinary treatment team, including cardiac surgeons and medical experts.
Collapse
Affiliation(s)
- Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo Nerima Hospital, Takanodai 3-1-10, Nerima- Ku, Tokyo, 177-8521, Japan.
| | - Daisuke Endo
- Department of Cardiovascular Surgery, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Akie Shimada
- Department of Cardiovascular Surgery, Juntendo Nerima Hospital, Takanodai 3-1-10, Nerima- Ku, Tokyo, 177-8521, Japan
| | - Satoshi Matsushita
- Department of Cardiovascular Surgery, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Tohru Asai
- Department of Cardiovascular Surgery, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| |
Collapse
|
5
|
Kim DW, Lee M, Lee KJ, Lee YH, Kim D, Shin SJ, Yoon HE. The combined clinical impact of red blood cell distribution width and vascular calcification on cardiovascular events and mortality in patients with end-stage kidney disease. Kidney Res Clin Pract 2022; 41:351-362. [PMID: 35286792 PMCID: PMC9184841 DOI: 10.23876/j.krcp.21.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 10/30/2021] [Indexed: 11/12/2022] Open
Abstract
Background Little is known about how the interaction between red blood cell distribution width (RDW) and vascular calcification (VC) affects cardiovascular (CV) events and mortality in end-stage kidney disease (ESKD) patients. This study investigated the combined prognostic effect of RDW and VC in ESKD patients starting dialysis. Methods A retrospective single-center study of 582 ESKD patients was conducted. VC was assessed by calculating the aortic calcification index (ACI) using computed tomography. Patients were divided into low ACI-low RDW, low ACI-high RDW, high ACI-low RDW, and high ACI-high RDW groups based on median ACI (17.12) and RDW (14.3) values. The association between RDW and VC and the composite endpoint of CV events and death was analyzed. Results During a median follow-up of 3.1 years (range, 1.5–5.5 years), 165 CV events (28.4%) and 124 deaths (21.4%) occurred. Cox regression showed that the low ACI-high RDW (adjusted hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.04–2.66; p = 0.03) and high ACI-low RDW (adjusted HR, 1.95; 95% CI, 1.21–3.14; p = 0.006) groups had a greater risk of CV events and death than the low ACI-low RDW group. The high ACI-high RDW group had the greatest risk (adjusted HR, 2.23; 95% CI, 1.42–3.52; p = 0.001). The effect of the interaction between ACI and RDW on CV events and mortality was statistically significant (p = 0.005). Conclusion High RDW and VC interact to increase the risk of CV events and death in ESKD patients.
Collapse
Affiliation(s)
- Da Won Kim
- Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Munpyo Lee
- Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kwon Jae Lee
- Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yeon Hee Lee
- Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dongryul Kim
- Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seok Joon Shin
- Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hye Eun Yoon
- Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Correspondence: Hye Eun Yoon Division of Nephrology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 56 Dongsu-ro, Bupyung-gu, Incheon 21431, Republic of Korea. E-mail:
| |
Collapse
|
6
|
Pan J, Borné Y, Gonçalves I, Persson M, Engström G. Associations of Red Cell Distribution Width With Coronary Artery Calcium in the General Population. Angiology 2021; 73:445-452. [PMID: 34814760 PMCID: PMC8969070 DOI: 10.1177/00033197211052124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Red cell distribution width (RDW) is a measure of the variability of erythrocyte volumes. RDW has been associated with incidence of cardiovascular diseases. However, the underlying mechanisms for the increased cardiovascular risk are still unclear. This study aimed to examine associations of RDW and coronary atherosclerosis in the general population. Computed tomography was performed and RDW was measured in fresh blood from 5772 subjects (aged 50–64 years) from the Swedish CArdioPulmonary bioImage Study (SCAPIS). Multinomial logistic regression was conducted to examine the associations between RDW and coronary artery calcium score (CACS). A total of 3902 (67.6%) individuals had low CACS (≤10), 18.6% had moderate CACS (>10 and ≤100) and 13.8% had high CACS (>100). The proportion with high CACS was 11.7%, 12.7%, 13.7% and 18.3%, respectively, in quartile 1–4 of RDW. After controlling for traditional risk factors, there were significant associations between RDW and high CACS: odds ratio = 1.51, 95% confidence interval: 1.18–1.94, and P = .001, for 4th vs 1st quartile of RDW. Elevated RDW is associated with coronary artery calcification in the middle-aged general population. RDW could be a reproducible and easily assessable biomarker of coronary calcification and cardiovascular risk.
Collapse
Affiliation(s)
- Jingxue Pan
- Department of Clinical Sciences in Malmö, 5193Lund University, Malmö, Sweden
| | - Yan Borné
- Department of Clinical Sciences in Malmö, 5193Lund University, Malmö, Sweden
| | - Isabel Gonçalves
- Department of Clinical Sciences in Malmö, 5193Lund University, Malmö, Sweden.,Department of Cardiology, Skåne University Hospital, Sweden
| | - Margaretha Persson
- Department of Clinical Sciences in Malmö, 5193Lund University, Malmö, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, 5193Lund University, Malmö, Sweden
| |
Collapse
|
7
|
Yamaoka H, Yamamoto T, Endo D, Shimada A, Matsushita S, Asai T, Amano A. Rapid decline in cardiac function in diabetic patients with calcified coronary artery disease undergoing hemodialysis: two case reports. BMC Cardiovasc Disord 2021; 21:271. [PMID: 34082711 PMCID: PMC8173516 DOI: 10.1186/s12872-021-02076-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 05/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinical symptoms of patients on dialysis do not match the signs of coronary disease progression, making the prediction of the true progression of their medical condition in clinical settings difficult. Emergency and concomitant surgeries are significant risk factors of mortality following open-heart surgery in patients on hemodialysis. CASE PRESENTATION We report two cases of successful coronary artery bypass grafting (CABG) in patients on dialysis with a history of cardiac surgery. The first case describes a 65-year-old woman who had undergone aortic valve replacement 2 years ago and was hospitalized urgently, because of a sudden decline in heart function and hypotension. She had moderate mitral regurgitation with right ventricular pressure of 66 mmHg and poor left ventricular function [left ventricular ejection fraction (LVEF), 40%]. Cineangiography revealed an increase in the rate of stenosis in the left main trunk, from 25 to 99% at admission, in addition to 100% occlusion in proximal left anterior descending artery (LAD) and 99% stenosis in the proximal left circumflex artery (LCX). We inserted an intra-aortic balloon pump preoperatively and performed emergency surgery (Euro II risk score, 61.7%; Society of Thoracic Surgeons (STS) risk score, 56.3%). The second case described a 78-year-old man who had undergone surgery for left atrial myxoma 4 years ago and was hospitalized urgently due to dyspnea, chest discomfort, and an LVEF of 44% (Euro II risk score, 40.7%; STS risk score, 33.2%). Cineangiography revealed an increase in the rate of stenosis in the proximal LAD, from 25% (4 years ago) to 90% at admission, in addition to 99% stenosis in proximal LCX and 95% stenosis in the posterolateral branch of LCX. Both patients underwent emergency CABG due to unstable hemodynamics and decreased left ventricular function despite regular dialysis. The surgeries were successful, and the patients were discharged without any complications. CONCLUSIONS In patients with multiple comorbidities and those who undergo dialysis treatment, calcified lesions in coronary arteries can progress severely and rapidly without any symptoms, including chest pain. Close outpatient management involving nephrologists and the cardiovascular team is necessary for patients on dialysis.
Collapse
Affiliation(s)
- Hironobu Yamaoka
- Department of Cardiovascular surgery, Edogawa Hospital, Higashi Koiwa 2-24-18, Edogawa-ku, Tokyo, 133-0052, Japan
| | - Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Daisuke Endo
- Department of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Akie Shimada
- Department of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Satoshi Matsushita
- Department of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Tohru Asai
- Department of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| |
Collapse
|
8
|
Chandra A, Raj G, Awasthi NP, Rao N, Srivastava D. Evaluation of the relationship between blood cell parameters and vascular calcification in dialysis-dependent end-stage renal disease patients. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2021; 31:136-143. [PMID: 32129206 DOI: 10.4103/1319-2442.279933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Coronary artery calcification is an acceptable tool for cardiovascular risk assessment in end-stage renal disease (ESRD) population. We aimed to identify the association and predictive value of components of blood cell parameters with coronary and thoracic aorta vascular calcification (VC) in ESRD population on dialysis. All ESRD patients receiving hemodialysis or peritoneal dialysis aged between 18 and 60 years were included in the study. Exclusion criteria comprised patients with active infection or inflammatory disease, autoimmune disease, congestive heart failure, angina pectoris and/or documented coronary artery disease, thyroid disease, and hepatic dysfunction. Agatston scoring was used for the evaluation of coronary aorta calcification (CAC) score (CACS) and thoracic aorta calcification (TAC) score (TACS). Compared to participants with no VC, those who had VC were statistically significantly older (P <0.001) and had higher neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) (P = 0.02 and <0.001, respectively). On multivariate logistic regression analysis, increasing age (P = 0.00) and higher PLR (P = 0.04) were associated with an increased likelihood of exhibiting VC (CAC or TAC). There was a positive correlation between CACS and age (rs = 0.495, P = 0.00). A statistically significant positive correlation existed between TACS and age (rs = 0.516, P = 0.00). Similarly, a positive correlation was found between NLR, PLR, and TACS (rs = 0.334, P = 0.001, and rs = 0.438, P = 0.00, respectively). On multivariate linear regression analysis, increased age and red cell distribution width were found to be significant predictors of log(n) TACS. PLR of 135 gave a sensitivity of 80% and a specificity of 50% for predicting VC. Being a cost-effective and easily available investigation, the utilization of the correlation of NLR and PLR with CAC and TAC appears promising, particularly in the age group of 30-60 years.
Collapse
Affiliation(s)
- Abhilash Chandra
- Department of Nephrology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Gaurav Raj
- Department of Radiodiagnosis, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Namrata P Awasthi
- Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Namrata Rao
- Department of Nephrology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Divya Srivastava
- Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| |
Collapse
|
9
|
Rondanelli M, Perna S, Alalwan TA, Cazzola R, Gasparri C, Infantino V, Perdoni F, Iannello G, Pepe D, Guido D. A structural equation model to assess the pathways of body adiposity and inflammation status on dysmetabolic biomarkers via red cell distribution width and mean corpuscular volume: a cross-sectional study in overweight and obese subjects. Lipids Health Dis 2020; 19:154. [PMID: 32590977 PMCID: PMC7320558 DOI: 10.1186/s12944-020-01308-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 06/02/2020] [Indexed: 12/21/2022] Open
Abstract
Background A study has been performed in overweight and obese subjects to assess the effects of adiposity and inflammation indicators on dysmetabolic biomarkers via red cell distribution width (RDW) and mean corpuscular volume (MCV), taking into account pro-antioxidant balance. Methods Data from 166 overweight subjects were analyzed by a path analysis model using structural equation modelling (SEM) to evaluate the direct and indirect pathway effects of adiposity, measured by body mass index (BMI) and waist circumference (WC), and inflammation status, measured by pro-antioxidant balance [reactive oxygen species (ROS)], lag-time and slope and C-reactive protein (CRP) values on dysmetabolic biomarkers, via RDW and MCV. Results BMI was strongly linked to CRP and ROS levels. Moreover, there was a significant negative decrease of MCV (1.546 femtoliters) linked to BMI indirectly via high CRP levels. Furthermore, WC affected RDW, indicating a possible mediatory role for RDW in relation to the relationship between WC and homeostatic model assessment (HOMA), insulin and high density lipoprotein (HDL), respectively. This was evident by the elevated HOMA and insulin levels and the decreased levels of HDL. Finally, ROS-related markers did not affect directly RDW and MCV. Conclusion The reported outcomes suggest that RDW might play a mediatory role in the relationship between WC and the dysmetabolic outcomes in overweight and obese individuals. CRP seems to modulate the linkage between BMI and MCV. This study provides the backbone structure for future scenarios and lays the foundation for further research on the role of RDW and MCV as suitable biomarkers for the assessment of cardiovascular disease (HDL-cholesterol), inflammatory bowels and insulin resistance.
Collapse
Affiliation(s)
- Mariangela Rondanelli
- IRCCS Mondino Foundation, 27100, Pavia, Italy.,Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100, Pavia, Italy
| | - Simone Perna
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, P. O. Box 32038, Zallaq, Kingdom of Bahrain
| | - Tariq A Alalwan
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, P. O. Box 32038, Zallaq, Kingdom of Bahrain
| | - Roberta Cazzola
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona "Istituto Santa Margherita", University of Pavia, 27100, Pavia, Italy.
| | - Vittoria Infantino
- Department of Biomedical Science and Human Oncology, University of Bari, 70121, Bari, Italy
| | - Federica Perdoni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona "Istituto Santa Margherita", University of Pavia, 27100, Pavia, Italy
| | - Giancarlo Iannello
- General Management, Azienda di Servizi alla Persona "Istituto Santa Margherita", 27100, Pavia, Italy
| | - Daniele Pepe
- Hasselt University, I-BioStat, Diepenbeek, Belgium
| | - Davide Guido
- Neurology, Public Health, Disability Unit, Scientific Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.,Epidemiology Unit, Agency for Health Protection of Milan, Milan, Italy
| |
Collapse
|
10
|
Erdal E, İnanir M. Platelet-to-lymphocyte ratio (PLR) and Plateletcrit (PCT) in young patients with morbid obesity. ACTA ACUST UNITED AC 2019; 65:1182-1187. [PMID: 31618335 DOI: 10.1590/1806-9282.65.9.1182] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 05/18/2019] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To compare the complete blood counts, namely the plateletcrit (PCT) and Platelet-To-Lymphocyte Ratio (PLR) of healthy subjects and those with morbid obesity in the young population. METHODS We included 45 patients with morbid obesity (body mass index -BMI - greater than or equal to 45 kg/m2) and 45 healthy subjects (BMI less than or equal to 25 kg/m2) in our study. Blood samples were obtained from the participants following a 12-hour fasting period. Then we evaluated the levels of hemoglobin (Hb), hematocrit (HCT), red cell distribution width (RDW), mean platelet volume (MPV), white blood cell (WBC), PLR, platelet counts, and PCT in the complete blood count. RESULTS The morbid obesity group had significantly higher platelet counts and PCT values (p<0.001), and PLR values (p=0.033). The value of WBC was also higher in the obese group (p=0.001). MPV was lower in the obesity group but not statistically significant (p=0.815). No significant difference was found between hemoglobin and hematocrit values in these groups; but RDW valuewere higher and statistically significant in the obese group (p=0.001). CONCLUSION PLR or PCT may be more useful as a marker in determining an increased thrombotic state and inflammatory response in morbid obesity.
Collapse
Affiliation(s)
- Emrah Erdal
- . Specialist Bolu Abant İzzet Baysal University, Medical Faculty, Department of Cardiology, Bolu, Turkey
| | - Mehmet İnanir
- . Specialist Bolu Abant İzzet Baysal University, Medical Faculty, Department of Cardiology, Bolu, Turkey
| |
Collapse
|
11
|
Khalil A, Shehata M, Abdeltawab A, Onsy A. Red blood cell distribution width and coronary artery disease severity in diabetic patients. Future Cardiol 2019; 15:355-366. [PMID: 31496273 DOI: 10.2217/fca-2018-0066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The purpose of the study is to evaluate the relationship between red blood cell distribution width (RDW) and coronary calcium score in diabetic patients. Methods: Hematological parameters of 100 diabetic (Type II) patients were assessed. Computed tomographic angiography was used to asses coronary artery calcium (CAC) score. Results: Mean age of the study cohort was 55 years (males: 60%). Mean RDW was 12.7%. Mean CAC score was 243. There was a significant correlation between RDW and each of: CAC scores (r = 0.53; p < 0.001) and severity of coronary artery disease (CAD; r = 0.25; p = 0.047). A cut-off value >14.2% (receiver operating characteristic curves) predicted CAC score >400. A cut-off value >-14.6% predicted the presence of significant CAD. Conclusion: Diabetic patients with high-CAC scores and significant CAD had higher RDW.
Collapse
Affiliation(s)
- Abdelrahman Khalil
- Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Shehata
- Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Adham Abdeltawab
- Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed Onsy
- Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| |
Collapse
|
12
|
den Harder AM, de Jong PA, de Groot MCH, Wolterink JM, Budde RPJ, Iŝgum I, van Solinge WW, Ten Berg MJ, Lutgens E, Veldhuis WB, Haitjema S, Hoefer IE, Leiner T. Commonly available hematological biomarkers are associated with the extent of coronary calcifications. Atherosclerosis 2018; 275:166-173. [PMID: 29920437 DOI: 10.1016/j.atherosclerosis.2018.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 06/01/2018] [Accepted: 06/08/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND AIMS We aimed to improve the understanding of potential associations between commonly available hematological biomarkers and the coronary artery calcification (CAC) score, which may help unravel the pathophysiology of coronary calcifications and subclinical coronary artery disease. METHODS A cross-sectional study was performed within the Utrecht Patient Oriented Database (UPOD). Patients with suspected or known coronary artery disease who underwent CT CAC scoring as well as standard hematology analysis that was part of routine clinical care (within 3 months of CT acquisition) were included. Complete hematology datasets were extracted from hematology analyzers. Linear regression adjusted for potential confounders was used to assess if hematological biomarkers were related to the CAC score. RESULTS In total, 1504 patients were included, of whom 43% (n = 647) had a CAC score of 0. Mean age (±SD) was 53 ± 13 years, and 34% of patients were women. Red blood cell distribution width (RDW, β = 0.20 [0.05-0.36], p=0.007), the fraction of immature reticulocytes (β = 0.97 [0.10-6.43], p=0.004), coefficient of variation of neutrophil lobularity (β = 0.13 [0.01-0.25], p=0.040) and mean lymphocyte cell size (β = 0.21 [0.08-0.34], p=0.001) were positively associated with the CAC score after adjustment for age, sex, body mass index (BMI), diabetes, glomerular filtration rate (GFR) and high-density lipoprotein (HDL). CONCLUSIONS This study confirms the known association of RDW with the CAC score, and presents the fraction of immature reticulocytes, coefficient of variation of neutrophil lobularity, and mean lymphocyte cell size as new markers associated with a higher CAC score.
Collapse
Affiliation(s)
- Annemarie M den Harder
- Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands.
| | - Pim A de Jong
- Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Mark C H de Groot
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Jelmer M Wolterink
- Image Sciences Institute, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Ricardo P J Budde
- Department of Radiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Ivana Iŝgum
- Image Sciences Institute, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Wouter W van Solinge
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Maarten J Ten Berg
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Esther Lutgens
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, the Netherlands; Institute for Cardiovascular Prevention, Ludwig-Maximilians-University, Munich, Germany
| | - Wouter B Veldhuis
- Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Saskia Haitjema
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Imo E Hoefer
- Image Sciences Institute, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Tim Leiner
- Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| |
Collapse
|
13
|
A Simple Blood Test, Such as Complete Blood Count, Can Predict Calcification Grade of Abdominal Aortic Aneurysm. Int J Vasc Med 2017; 2017:1370751. [PMID: 28948050 PMCID: PMC5602620 DOI: 10.1155/2017/1370751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 07/16/2017] [Indexed: 01/04/2023] Open
Abstract
Objective The pathogenesis of abdominal aortic aneurysm (AAA) is complex and different factors, including calcification, are linked to increased complications. This study was conducted in order to verify if classical risk factors for AAA and cell blood count parameter could help in the identification of calcification progression of the aneurysm. Design Risk factors were collected and cell blood count was performed in patients with AAA and patients were analyzed for the presence of aorta calcification using CT angiography. Results We found no association of calcification grade with risk factors for AAA but we found a strong association between MCV, MCH, and calcification grade. Instead, no association was found with the other parameter that we analyzed. Conclusions In this study, we demonstrate that biomarkers such as MCV and MCH could have potential important information about AAA calcification progression and could be useful to discriminate between those patients that should undergo a rapid imaging, thus allowing prompt initiation of treatment of suspicious patients that do not need imaging repetition.
Collapse
|
14
|
Sun X, Luo L, Zhao X, Ye P, Du R. The neutrophil-to-lymphocyte ratio on admission is a good predictor for all-cause mortality in hypertensive patients over 80 years of age. BMC Cardiovasc Disord 2017. [PMID: 28646855 PMCID: PMC5483279 DOI: 10.1186/s12872-017-0595-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Immuno-inflammation plays a major role in the process of hypertension. We aimed to evaluate the association between inflammatory markers, neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW) and all-cause mortality in elderly patients with hypertension. METHODS A total of 341 hypertensive patients over 80 years of age were included to this study. The NLR and RDW were measured on admission and all the selected patients were followed up for up to 90 days. Kaplan-Meier curves were plotted to evaluate the association between the NLR and the all-cause mortality at follow-up. Using Cox regression models, we investigated the prognostic value of NLR and RDW for all-cause mortality. RESULTS Patients with higher quartile of NLR linked to high mortality in hypertensive patients at 90 day after admission (16.47%,13.25%,1.14%,1.17% respectively; χ2 = 20.581,P = 0.000). Surviving patients had lower RDW (13.61 ± 1.37 VS 14.18 ± 1.38, p = 0.041) and NLR (4.97 ± 5.72 VS 7.95 ± 6.88,p = 0.011). The receiver operating curve (ROC) of the NLR for all-cause mortality had an area under the curve (AUC) =0.714 (95%CI: 0.629-0.798, P = 0.000), with acritical value of 2.97, with sensitivity of 92.6%, and a specificity of 52.5%. The ROC of the RDW to predict all-cause mortality, had an AUC =0.654 (95%CI:0.548-0.761, P = 0.008), with acritical value of 13.2%.The Kaplan-Meier curve showed a significant difference between different NLR levels (p = 0.002). Multivariate Cox proportional hazard analysis shown 3rd quartile of NLR(RR = 9.646, 95% CI 1.302-34.457, P = 0.041) and 4th quartiles(RR = 16.451, 95% CI 2.137-66.643, P = 0.007) were found to independently predict all-cause death in hypertensive patients over 80 years of age. Higher rank of NLR was link to higher incidence of all-cause death for such patients. CONCLUSION The findings of the present study demonstrate the potential utility of NLR in risk stratification of elderly patients with hypertension to provide information for clinical treatment strategies.
Collapse
Affiliation(s)
- Xiaonan Sun
- Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Leiming Luo
- Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China.
| | - Xiaoqian Zhao
- Department of Cardiology, Chinese People's Liberation Army 305 Hospital, Beijing, 100000, China
| | - Ping Ye
- Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Ruixue Du
- Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| |
Collapse
|
15
|
Balta S, Yildirim AO, Ozturk C. Red Cell Distribution Width and Coronary Artery Calcification. Korean Circ J 2016; 46:270-2. [PMID: 27014361 PMCID: PMC4805575 DOI: 10.4070/kcj.2016.46.2.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 11/24/2015] [Indexed: 11/18/2022] Open
Affiliation(s)
- Sevket Balta
- Department of Cardiology, Gulhane Medical Academy, Ankara, Turkey
| | | | - Cengiz Ozturk
- Department of Cardiology, Gulhane Medical Academy, Ankara, Turkey
| |
Collapse
|
16
|
Red cell distribution width is a novel biomarker that predicts excess body-mass index loss 1 year after laparoscopic Roux-en-Y gastric bypass. Surg Endosc 2016; 30:4607-12. [PMID: 26902617 DOI: 10.1007/s00464-016-4798-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 02/03/2016] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Bariatric surgery is the most effective method for producing sustained weight loss, improving obesity-associated comorbidities and reducing inflammation in the morbidly obese population. The red cell distribution width (RDW) is a novel marker of inflammation that is usually reported as part of a complete blood count. In this study, we tested our hypothesis that red cell distribution width might represent a novel biomarker predictive of excess body-mass index loss (EBMIL) following laparoscopic Roux-en-Y gastric bypass (LRYGB). METHODS Five hundred and forty-seven LRYGB patients included from a single institution were individually reviewed, noting both preoperative RDW and percent excess BMI loss at 6 months and 1 year post-LRYGB (%EBMIL180 and %EBMIL365, respectively). Bivariate and multivariate linear regression analysis was conducted between age, gender, initial body-mass index (BMI0) and RDW and each of the two endpoints, to assess the independence of RDW as a predictor of postoperative success. RESULTS The median RDW was 13.9 (13.3-14.6) %, and median EBMIL180 and EBMIL365 were 55.4 (45.2-66.7) % and 71.3 (58.9-87.8) %, respectively. After controlling for age, gender and BMI0, RDW was associated with %EBMIL365 (B = -1.4 [-2.8 to -0.002] %, P = .05), but not %EBMIL180 (B = -0.6 [-1.6 to 0.5] %, P = .30. Upon Kruskal-Wallis analysis, patients with a preoperative RDW > 15.0 % had significantly lower %EBMIL than those in the <13.0 % (P < .001) and 13.0-15.0 % (P < .01) strata. CONCLUSIONS RDW is predictive of EBMIL at 1 year following LRYGB. This represents a novel preoperative biomarker that may provide clinically useful prognostic information.
Collapse
|