Association between red cell distribution width and mortality after cardiac resynchronization therapy

Guy Topaz, Moti Haim, Jairo Kusniec, Shirit Kazum, Gustavo Goldenberg, Gregory Golovchiner, Ran Kornowski, Boris Strasberg, Alon Eisen

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)505-509
Number of pages5
JournalIsrael Medical Association Journal
Volume17
Issue number8
StatePublished - 1 Aug 2015
Externally publishedYes

Keywords

  • Cardiac resynchronization therapy (CRT)
  • Congestive heart failure (CHF)
  • Mortality
  • Re-hospitalization
  • Red cell distribution width (RDW)

ASJC Scopus subject areas

  • Medicine (all)

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