红细胞分布宽度与房颤患者血栓栓塞事件的关系。
Association between red cell distribution width and thromboembolic events in patients with atrial fibrillation.
机构信息
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
出版信息
Eur J Intern Med. 2017 Dec;46:41-46. doi: 10.1016/j.ejim.2017.07.028. Epub 2017 Aug 4.
BACKGROUND
We investigated whether an increase in the value of red cell distribution width (RDW) was associated with thromboembolic outcomes in patients with atrial fibrillation (AF).
METHODS
We performed a retrospective analysis of 5082 consecutive patients with non-valvular AF. Thromboembolic events (N=723, 14.2%) were recorded and analysed according to RDW value.
RESULTS
The peak RDW value during follow-up was higher in patients with thromboembolic events than in those without thromboembolic events (15.1% vs. 14.2%, p<0.001). The RDW value showed similar power in predicting thromboembolic outcomes compared with the factor of age. The risk of thromboembolic events was higher in patients with a peak RDW≥13.9% than in patients with a peak RDW<13.9% (hazard ratio 1.63, p<0.001), and increased with each quartile increase of RDW. In a subgroup of 739 patients with congestive heart failure (CHF), there were 112 (15.2%) thromboembolic events. The peak RDW value of patients with CHF with thromboembolic events was also significantly higher (16.4% vs. 15.6%, p=0.019) compared to that of those without thromboembolic events.
CONCLUSION
An increased RDW value during follow-up could be associated with thromboembolic events in patients with non-valvular AF. The suggested cut-off values for RDW used to predict an increased thromboembolic risk in were ≥13.9% in patients with AF in general, ≥15% in patients with co-existing AF and CHF.
背景
我们研究了红细胞分布宽度（RDW）值的增加是否与非瓣膜性心房颤动（AF）患者的血栓栓塞结局相关。
方法
我们对 5082 例连续的非瓣膜性 AF 患者进行了回顾性分析。根据 RDW 值记录并分析血栓栓塞事件（N=723，14.2%）。
结果
随访期间，发生血栓栓塞事件的患者的 RDW 值峰值高于未发生血栓栓塞事件的患者（15.1%比 14.2%，p<0.001）。RDW 值在预测血栓栓塞结局方面与年龄因素具有相似的作用。RDW 值峰值≥13.9%的患者发生血栓栓塞事件的风险高于 RDW 值峰值<13.9%的患者（危险比 1.63，p<0.001），且随着 RDW 值每增加一个四分位，风险增加。在 739 例伴有充血性心力衰竭（CHF）的患者亚组中，有 112 例（15.2%）发生血栓栓塞事件。伴有 CHF 和血栓栓塞事件的患者的 RDW 值峰值也明显更高（16.4%比 15.6%，p=0.019）。
结论
非瓣膜性 AF 患者随访期间 RDW 值的增加可能与血栓栓塞事件相关。用于预测 AF 患者血栓栓塞风险增加的 RDW 截断值一般为≥13.9%，伴有 CHF 的患者为≥15%。
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