Department of Cardiology, Division of Cardiovascular and Respiratory Studies, Postgraduate Medical Institute, Castle Hill Hospital, Kingston-upon-Hull, East Yorkshire, UK.
Eur J Heart Fail. 2009 Dec;11(12):1155-62. doi: 10.1093/eurjhf/hfp147.
Red cell distribution width (RDW) is prognostic in patients with heart failure (HF), but it has not been compared with N-terminal brain natriuretic peptide (NT-proBNP). We sought to make this comparison.
Patients referred to a specialist HF clinic between 2001 and 2008 were assessed comprehensively including medical history, echocardiogram, and blood tests. Cox-regression was used to assess the multivariable relationship between RDW, NT-proBNP, and all-cause mortality. A total of 1087 patients were recruited; median (IQR) follow-up was 52 months (29-66); age 72 years (64-78); 74% male; 70% ischaemic heart disease; 20% diabetic; 85% NYHA >or= 2, and 63% with at least moderate LV impairment (EF < 35% equivalent). In a multivariable model, both RDW and NT-proBNP were independently prognostic (RDW: chi(2) = 21.8 vs. 49.1 both P < 0.001). In a model using quartiles of each variable, the relative risk for each was similar for the second and third quartiles compared with the first. A larger increase in risk for NT-proBNP is seen in the fourth quartile.
Red cell distribution width is a readily available test in the HF-population with similar independent prognostic power to NT-proBNP across the first to third quartiles. Prognostic models in HF should include RDW and further investigation is necessary to determine the pathological mechanism of the relationship.
红细胞分布宽度（RDW）对心力衰竭（HF）患者具有预后价值，但尚未将其与 N 末端脑钠肽前体（NT-proBNP）进行比较。我们旨在进行这项比较。
2001 年至 2008 年间，在专科 HF 诊所就诊的患者接受了全面评估，包括病史、超声心动图和血液检查。Cox 回归用于评估 RDW、NT-proBNP 与全因死亡率的多变量关系。共纳入 1087 例患者；中位（IQR）随访时间为 52 个月（29-66）；年龄 72 岁（64-78）；74%为男性；70%为缺血性心脏病；20%为糖尿病；85%NYHA >或= 2，63%至少存在中度 LV 损伤（EF < 35%）。在多变量模型中，RDW 和 NT-proBNP 均具有独立的预后价值（RDW：chi(2) = 21.8 比 49.1，均 P < 0.001）。在使用每个变量四分位数的模型中，第二和第三个四分位与第一个四分位相比，每个四分位的相对风险相似。第四四分位的 NT-proBNP 风险增加更大。
RDW 是 HF 人群中一种易于获得的检测方法，其在第一至第三四分位的独立预后能力与 NT-proBNP 相似。HF 预后模型应包括 RDW，进一步的研究需要确定这种关系的病理机制。
