Prognostic Value of Change in Red Cell Distribution Width 1 Month After Discharge in Acute Decompensated Heart Failure Patients

Abstract

Background: Red cell distribution width (RDW) is a novel prognostic marker independently associated with adverse outcomes in acute decompensated heart failure (ADHF) patients. The aim of the present study was to assess whether the change in RDW after discharge had prognostic value in patients with ADHF. Methods and Results: RDW was measured in 261 patients admitted with ADHF, at admission and at discharge and 1 month after discharge. Cardiovascular (CV) events were defined as CV mortality and heart failure rehospitalization. Kaplan-Meier analysis showed that patients with positive RDW change between admission and 1 month after discharge (RDWΔ_1Mdis-adm; n=136) had a significantly higher number of CV events compared with patients with no positive RDWΔ_1Mdis-adm (n=125; 60.3% vs. 47.2%, log-rank: P=0.007). On Cox hazards analysis, a positive RDWΔ_1Mdis-adm was an independent predictor of CV events after adjusting for other CV risk factors (hazard ratio, 1.740; 95% confidence interval: 1.149-2.633, P=0.009). Conclusions: A novel relationship was noted between positive RDWΔ_1Mdis-adm and CV events in ADHF patients. Measurement of RDW at 1 month after ADHF assists in the prediction of adverse CV outcomes. Therefore, repeated measurement of RDW is a simple and inexpensive method that may facilitate assessment of CV risk stratification in patients with ADHF. (Circ J 2012; 76: 109-116)