房颤患者中红细胞分布宽度升高与长期预后的关系。

The relationship between elevated red cell distribution width and long-term outcomes among patients with atrial fibrillation.

作者信息

Wan Huaibin, Yang Yanmin, Zhu Jun, Huang Bi, Wang Juan, Wu Shuang, Shao Xinghui, Zhang Han

机构信息

Emergency and Intensive Care Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

出版信息

Clin Biochem. 2015 Aug;48(12):762-7. doi: 10.1016/j.clinbiochem.2015.06.001. Epub 2015 Jun 5.

DOI:10.1016/j.clinbiochem.2015.06.001

PMID:26054582

Abstract

OBJECTIVES

Red cell distribution width (RDW) is associated with the incidence of atrial fibrillation (AF). The aim of this study was to evaluate the relationship between elevated RDW and long-term clinical outcomes among patients with AF.

DESIGN AND METHODS

We prospectively observed 300 consecutive patients with AF (50.3% males, mean age 62.6 ± 12.9 years) between February 2009 and October 2011. Baseline RDW levels and clinical data were collected. The primary clinical outcomes of interest included all-cause mortality and the incidence of major adverse events (MAEs).

RESULTS

During a median follow-up period of 3.2 years, 60 deaths and 92 MAEs were recorded. From the lowest to the highest RDW quartile, an increased risk of mortality (2.76, 3.98, 8.40 and 13.77 per 100 person-years, respectively) and an incidence of MAEs (6.46, 8.18, 13.79 and 20.27 per 100 person-years, respectively) were noted. In a multivariate Cox regression analysis, RDW was independently associated with both all-cause mortality (hazard ratio (HR): 1.024; 95% confidence interval (CI): 1.012-1.036, P < 0.001) and MAEs (HR: 1.012; 95% CI: 1.002-1.023, P = 0.023). A receiver operating characteristic (ROC) analysis revealed that RDW predicted both mortality and MAEs with areas under the ROC curves (AUCs) of 0.682 (P < 0.001) and 0.617 (P = 0.001); the best cutoff points were 13.85% and 13.55%, respectively.

CONCLUSIONS

Elevated RDW is an independent predictor of long-term adverse clinical outcomes, including all-cause mortality and MAEs, among patients with AF.

摘要

目的

红细胞分布宽度（RDW）与房颤（AF）的发生率相关。本研究旨在评估AF患者中RDW升高与长期临床结局之间的关系。

设计与方法

我们前瞻性地观察了2009年2月至2011年10月期间连续的300例AF患者（男性占50.3%，平均年龄62.6±12.9岁）。收集了基线RDW水平和临床数据。感兴趣的主要临床结局包括全因死亡率和主要不良事件（MAE）的发生率。

结果

在中位随访期3.2年期间，记录了60例死亡和92例MAE。从最低到最高的RDW四分位数，死亡率风险增加（分别为每100人年2.76、3.98、8.40和13.77），MAE发生率增加（分别为每100人年6.46、8.18、13.79和20.27）。在多变量Cox回归分析中，RDW与全因死亡率（风险比（HR）：1.024；95%置信区间（CI）：1.012 - 1.036，P < 0.001）和MAE（HR：1.012；95%CI：1.002 - 1.023，P = 0.023）均独立相关。受试者工作特征（ROC）分析显示，RDW预测死亡率和MAE的ROC曲线下面积（AUC）分别为0.682（P < 0.001）和0.617（P = 0.001）；最佳截断点分别为13.85%和13.55%。