Guray Yesim, Ipek Esra Gucuk, Guray Umit, Demirkan Burcu, Kafes Habibe, Asarcikli Lale Dinc, Cabuk Gizem, Yilmaz Mehmet Birhan
Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
Arch Cardiovasc Dis. 2014 May;107(5):299-307. doi: 10.1016/j.acvd.2014.04.008. Epub 2014 Jun 9.
Infective endocarditis (IE) is associated with significant morbidity and mortality. Red cell distribution width (RDW) is a recently recognized biomarker of adverse outcome in a number of acute and chronic conditions.
To investigate the relationship between RDW and 1-year survival in patients with IE.
Clinical records from two tertiary centres were used to analyze data from patients with definite IE. Clinical, echocardiographic and biochemical variables were evaluated along with RDW. One-year survival status after index hospitalization was identified for each patient.
One hundred consecutive patients (mean age 47.8±16.7 years; 61% men) with definite IE were enrolled. According to receiver operating characteristic curve analysis, the optimal RDW cut-off value for predicting mortality was 15.3% (area under the curve 0.70; P=0.001). Forty-one patients (41%) died within 1 year; of these, 88% had RDW results>15.3%. Univariate Cox proportional-hazards analysis showed that RDW>15.3%, heart failure, renal failure, cardiac abscess, severe valvular regurgitation and presence of dehiscence were associated with increased mortality. Multivariable Cox proportional-hazards analysis revealed that renal failure (hazard ratio [HR] 3.21, 95% confidence interval [CI] 1.35-7.59; P=0.008), heart failure (HR 2.77, 95% CI 1.1-6.97; P=0.03) and RDW>15.3% (HR 3.07, 95% CI 1.06-8.86; P=0.03) were independent predictors of mortality in patients with IE.
According to our results, mortality is high in patients with IE. RDW is a promising biomarker for predicting 1-year survival rates in these patients.
感染性心内膜炎（IE）与显著的发病率和死亡率相关。红细胞分布宽度（RDW）是最近在许多急性和慢性疾病中被认可的不良预后生物标志物。
研究IE患者中RDW与1年生存率之间的关系。
使用来自两个三级中心的临床记录分析确诊为IE的患者的数据。评估临床、超声心动图和生化变量以及RDW。确定每位患者在首次住院后的1年生存状态。
纳入了100例确诊为IE的连续患者（平均年龄47.8±16.7岁；61%为男性）。根据受试者工作特征曲线分析，预测死亡率的最佳RDW临界值为15.3%（曲线下面积0.70；P=0.001）。41例患者（41%）在1年内死亡；其中，88%的患者RDW结果>15.3%。单因素Cox比例风险分析显示，RDW>15.3%、心力衰竭、肾衰竭、心脏脓肿、严重瓣膜反流和存在裂开与死亡率增加相关。多因素Cox比例风险分析显示，肾衰竭（风险比[HR]3.21，95%置信区间[CI]1.35 - 7.59；P=0.008）、心力衰竭（HR 2.77，95% CI 1.1 - 6.97；P=0.03）和RDW>15.3%（HR 3.07，95% CI 1.06 - 8.86；P=0.03）是IE患者死亡率的独立预测因素。
根据我们的结果，IE患者死亡率很高。RDW是预测这些患者1年生存率的有前景的生物标志物。
