红细胞分布宽度与室间隔心肌切除术后不良心血管事件相关。

Red blood cell distribution width is associated with adverse cardiovascular events after septal myectomy.

作者信息

Wang Shengwei, Song Changpeng, Cui Hao, Zhu Changsheng, Wu Rong, Huang Xiaohong, Lai Yongqiang, Wang Shuiyun

机构信息

Department of Cardiovascular Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vascular Diseases, Beijing, China.

Department of Special Medical Treatment Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

J Thorac Dis. 2021 Feb;13(2):582-591. doi: 10.21037/jtd-20-2528.

DOI:10.21037/jtd-20-2528

PMID:33717531

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7947493/

Abstract

BACKGROUND

Red blood cell distribution width (RDW) is associated with increased morbidity and mortality in several cardiovascular diseases. However, the prognostic significance of RDW in patients with hypertrophic obstructive cardiomyopathy (HOCM) who underwent septal myectomy remains unclear as no studies have been conducted on this topic. This study aimed to assess the prognostic significance of RDW in these patients.

METHODS

A total of 867 adults with HOCM who underwent septal myectomy at Fuwai Hospital from 2011 to 2017 were retrospectively studied. All patients were assessed comprehensively, including their medical history, echocardiograms, and blood test results.

RESULTS

The median age of patients was 47.9 [interquartile range (IQR), 37.0-56.0] years and 61.5% of patients were men. During a median follow-up period of 32 (IQR, 17-53) months, 26 patients died and 23 had a cardiovascular death during follow-up. Compared to patients in the lowest RDW quartile, those in the highest quartile had a significantly lower 5-year survival free from all-cause and cardiovascular death (95.9% 87.6%, P<0.001; 95.9% 89.9%, P<0.001). Compared with lower RDW, higher RDW was significantly associated with all-cause and cardiovascular death after adjustment for age, sex, body mass index, and relevant clinical risk factors [per RDW standard deviation (SD) hazard ratio (HR) increase =1.76, 95% confidence interval (CI): 1.54-2.05, P<0.001; per RDW SD HR =1.91, 95% CI: 1.63-2.22, P for trend <0.001].

CONCLUSIONS

Higher RDW is independently associated with all-cause and cardiovascular death in patients with HOCM after septal myectomy. Therefore, this readily available biomarker could be considered as an additive biomarker for risk stratification in these patients.

摘要

背景

红细胞分布宽度（RDW）与多种心血管疾病的发病率和死亡率增加相关。然而，对于接受室间隔心肌切除术的肥厚性梗阻性心肌病（HOCM）患者，RDW的预后意义尚不清楚，因为尚未有关于该主题的研究。本研究旨在评估RDW在这些患者中的预后意义。

方法

回顾性研究了2011年至2017年在阜外医院接受室间隔心肌切除术的867例成年HOCM患者。对所有患者进行了全面评估，包括病史、超声心动图和血液检查结果。

结果

患者的中位年龄为47.9岁[四分位间距（IQR），37.0 - 56.0岁]，61.5%为男性。在中位随访期32个月（IQR，17 - 53个月）内，26例患者死亡，23例在随访期间发生心血管死亡。与RDW最低四分位数的患者相比，最高四分位数的患者全因死亡和心血管死亡的5年生存率显著降低（95.9%对87.6%，P<0.001；95.9%对89.9%，P<0.001）。在调整年龄、性别、体重指数和相关临床危险因素后，与较低的RDW相比，较高的RDW与全因死亡和心血管死亡显著相关[每增加1个RDW标准差（SD），风险比（HR）增加 = 1.76，95%置信区间（CI）：1.54 - 2.05，P<0.001；每增加1个RDW SD，HR = 1.91，95% CI：1.63 - 2.22，趋势P<0.001]。