Liu Sen, Wang Ping, Shen Ping-Ping, Zhou Jian-Hua
Department of Cardiology, Affiliated Weihai Central Hospital of Weifang Medical College, Wendeng, Shandong, China (mainland).
Med Sci Monit. 2016 Jun 21;22:2119-25. doi: 10.12659/msm.898103.
BACKGROUND This retrospective study was performed to evaluate the value of baseline red blood cell distribution width (RDW) for predicting the severity of chronic heart failure (CHF) compared with N-terminal prohormone brain natriuretic peptide (NT-ProBNP) and other hematological and biochemical parameters. MATERIAL AND METHODS Hematological and biochemical parameters were obtained from 179 patients with New York Heart Association (NYHA) CHF class I (n=44), II (n=39), III (n=41), and IV (n=55). Receiver operator characteristic (ROC) curves were used for assessing predictive values. RESULTS RDW increased significantly in class III and IV compared with class I (14.3±2.3% and 14.3±1.7% vs. 12.9±0.8%, P<0.01). Areas under ROCs (AUCs) of RDW and NT-ProBNP for class IV HF were 0.817 and 0.840, respectively. RDW was markedly elevated in the mortality group compared with the survival group (13.7±1.7 vs. 15.8±1.8, P<0.01). The predictive value of RDW was lower than that of NT-ProBNP but was comparable to white blood cell (WBC), neutrophil (NEU), lymphocyte (L), and neutrophil/lymphocyte ratio (N/L) for mortality during hospitalization, with AUCs of 0.837, 0.939, 0.858, 0.891, 0.885, and 0.885, respectively. RDW and NT-proBNP showed low predictive values for repeated admission (≥3). RDW was an independent risk factor for mortality (OR=2.531, 95% CI: 1.371-4.671). CONCLUSIONS RDW increased significantly in class III and IV patients and in the mortality group. The predictive value of RDW is comparable to NT-proBNP for class IV and lower than that of NT-proBNP for mortality. Elevated RDW is an independent risk factor for mortality.
本回顾性研究旨在评估基线红细胞分布宽度（RDW）与N末端脑钠肽前体（NT-ProBNP）及其他血液学和生化参数相比，对预测慢性心力衰竭（CHF）严重程度的价值。
获取179例纽约心脏协会（NYHA）心功能分级为I级（n = 44）、II级（n = 39）、III级（n = 41）和IV级（n = 55）的CHF患者的血液学和生化参数。采用受试者工作特征（ROC）曲线评估预测价值。
与I级相比，III级和IV级患者的RDW显著升高（14.3±2.3%和14.3±1.7% vs. 12.9±0.8%，P<0.01）。IV级心力衰竭患者RDW和NT-ProBNP的ROC曲线下面积（AUC）分别为0.817和0.840。与存活组相比，死亡组的RDW显著升高（13.7±1.7 vs. 15.8±1.8，P<0.01）。住院期间，RDW对死亡率的预测价值低于NT-ProBNP，但与白细胞（WBC）、中性粒细胞（NEU）、淋巴细胞（L）及中性粒细胞/淋巴细胞比值（N/L）相当，其AUC分别为0.837、0.939、0.858、0.891、0.885和0.885。RDW和NT-proBNP对再次入院（≥3次）的预测价值较低。RDW是死亡的独立危险因素（OR = 2.531，95%CI：1.371 - 4.671）。
III级和IV级患者以及死亡组的RDW显著升高。RDW对IV级的预测价值与NT-proBNP相当，对死亡率的预测价值低于NT-proBNP。RDW升高是死亡的独立危险因素。
