Usefulness of Red Cell Distribution Width to Predict Mortality in Patients With Peripheral Artery Disease

Increased red blood cell distribution width (RDW), a marker of anisocytosis, has been associated with adverse outcomes in multiple settings. Whether RDW is predictive of mortality in patients with peripheral artery disease (PAD) is unknown. We studied 13,039 consecutive outpatients (69.5 ± 12.0 year...

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Veröffentlicht in:The American journal of cardiology Jg. 107; H. 8; S. 1241 - 1245
Hauptverfasser: Ye, Zi, Smith, Carin, Kullo, Iftikhar J.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: New York, NY Elsevier Inc 15.04.2011
Elsevier
Elsevier Limited
Schlagworte:
Aged
Biological and medical sciences
Biomarkers
Cardiology. Vascular system
Cardiovascular
Cardiovascular disease
Erythrocyte Count
Erythrocyte Volume
Erythrocytes
Female
Follow-Up Studies
Humans
Male
Medical sciences
Mortality
Peripheral Arterial Disease - blood
Peripheral Arterial Disease - mortality
Prognosis
Retrospective Studies
Risk Factors
Survival Rate - trends
United States - epidemiology
Vein & artery diseases
United States
Human
Prognosis
Disease
Mortality
Distribution
Red blood cell
Patient
Circulatory system
Cardiology
Predictive factor
Width
Artery
ISSN:0002-9149, 1879-1913, 1879-1913
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Zusammenfassung:Increased red blood cell distribution width (RDW), a marker of anisocytosis, has been associated with adverse outcomes in multiple settings. Whether RDW is predictive of mortality in patients with peripheral artery disease (PAD) is unknown. We studied 13,039 consecutive outpatients (69.5 ± 12.0 years of age, 60.9% men, 97.6% white) with PAD identified by noninvasive lower-extremity arterial testing at the Mayo Clinic from January 1997 through December 2007, with follow-up through September 2009. We defined PAD as a low (≤0.9) or high (≥1.4) ankle–brachial index (ABI). Cardiovascular risk factors and co-morbidities were ascertained using electronic medical record–based algorithms. RDW was obtained from the complete blood cell count drawn around the time of arterial evaluation. Mortality was ascertained using the Mayo electronic medical record and Accurint databases. Association of RDW with all-cause mortality was analyzed by multivariable Cox proportional hazards regression. During a median follow-up of 5.5 years, 4,039 (31.0%) deaths occurred (28.7% in low and 38.9% in high ABI subsets). After adjustment for age, gender, cardiovascular risk factors, and co-morbidities, patients in the highest quartile of RDW (>14.5%) had a 66% greater risk of mortality compared to the lowest quartile (<12.8%, p <0.0001); a 1% increment in RDW was associated with a 10% greater risk of all-cause mortality (hazard ratio 1.10, 95% confidence interval 1.08 to 1.12, p <0.0001). The adjusted hazard ratio was similar in the low (1.10, 1.08 to 1.12) and high (1.09, 1.06 to 1.12) ABI subsets. In conclusion, RDW, a routinely available measurement, is an independent prognostic marker in patients with PAD.
Bibliographie:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
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ISSN:0002-9149
1879-1913
1879-1913
DOI:10.1016/j.amjcard.2010.12.023