TY - JOUR
T1 - Association between red cell distribution width and mortality after cardiac resynchronization therapy
AU - Topaz, Guy
AU - Haim, Moti
AU - Kusniec, Jairo
AU - Kazum, Shirit
AU - Goldenberg, Gustavo
AU - Golovchiner, Gregory
AU - Kornowski, Ran
AU - Strasberg, Boris
AU - Eisen, Alon
N1 - Publisher Copyright:
© 2015, Israel Medical Association. All rights reserved.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - Background: Cardiac resynchronization therapy (CRT) is a non-pharmacological option for patients with heart failure and interventricular dyssynchrony. Elevated red cell distribution width (RDW) reflects higher size and heterogeneity of erythrocytes and is associated with poor outcome in patients with chronic heart failure. Objectives: To examine the association between RDW levels and outcomes after CRT implantation. Methods: We conducted a cohort analysis of 156 patients (126 men, median age 69.0 years) who underwent CRT implantation in our institution during 2004–2008. RDW was measured at three time points before and after implantation. Primary outcome was defined as all-cause mortality, and secondary outcome as hospital re-admissions. We investigated the association between RDW levels and primary outcome during a median follow-up of 61 months. Results: Ninety-five patients (60.9%) died during follow-up. Higher baseline RDW levels were associated with all-cause mortality (unadjusted HR 1.35, 95%CI 1.20–1.52, P < 0.001). On multivariate analysis adjusted for clinical, electrocardiographic and laboratory variables, baseline RDW levels were associated with mortality (HR 1.33, 95%CI 1.16–1.53). RDW levels 6 months and 12 months post-implantation were also associated with mortality (HR 1.22, 95%CI 1.08–1.38, P = 0.001; and HR 1.15, 95%CI 1.01–1.32, P = 0.02, respectively). Patients who were re-admitted to hospital during follow-up (n=78) had higher baseline RDW levels as compared to those who were not (14.9%, IQR 14.0, 16.0% vs. 14.3%, IQR 13.7, 15.0%, respectively, P = 0.03). Conclusion: An elevated RDW level before and after CRT implantation is independently associated with all-cause mortality.
AB - Background: Cardiac resynchronization therapy (CRT) is a non-pharmacological option for patients with heart failure and interventricular dyssynchrony. Elevated red cell distribution width (RDW) reflects higher size and heterogeneity of erythrocytes and is associated with poor outcome in patients with chronic heart failure. Objectives: To examine the association between RDW levels and outcomes after CRT implantation. Methods: We conducted a cohort analysis of 156 patients (126 men, median age 69.0 years) who underwent CRT implantation in our institution during 2004–2008. RDW was measured at three time points before and after implantation. Primary outcome was defined as all-cause mortality, and secondary outcome as hospital re-admissions. We investigated the association between RDW levels and primary outcome during a median follow-up of 61 months. Results: Ninety-five patients (60.9%) died during follow-up. Higher baseline RDW levels were associated with all-cause mortality (unadjusted HR 1.35, 95%CI 1.20–1.52, P < 0.001). On multivariate analysis adjusted for clinical, electrocardiographic and laboratory variables, baseline RDW levels were associated with mortality (HR 1.33, 95%CI 1.16–1.53). RDW levels 6 months and 12 months post-implantation were also associated with mortality (HR 1.22, 95%CI 1.08–1.38, P = 0.001; and HR 1.15, 95%CI 1.01–1.32, P = 0.02, respectively). Patients who were re-admitted to hospital during follow-up (n=78) had higher baseline RDW levels as compared to those who were not (14.9%, IQR 14.0, 16.0% vs. 14.3%, IQR 13.7, 15.0%, respectively, P = 0.03). Conclusion: An elevated RDW level before and after CRT implantation is independently associated with all-cause mortality.
KW - Cardiac resynchronization therapy (CRT)
KW - Congestive heart failure (CHF)
KW - Mortality
KW - Re-hospitalization
KW - Red cell distribution width (RDW)
UR - http://www.scopus.com/inward/record.url?scp=84940380390&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:84940380390
SN - 1565-1088
VL - 17
SP - 505
EP - 509
JO - Israel Medical Association Journal
JF - Israel Medical Association Journal
IS - 8
ER -