Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May 10;4(1):66-72.
doi: 10.14744/nci.2017.72324. eCollection 2017.

Increased levels of red cell distribution width is correlated with presence of left atrial stasis in patients with non-valvular atrial fibrillation

Adnan Kaya  1 , Ceyhan Tukkan  2 , Ahmet Taha Alper  2 , Baris Gungor  2 , Kazim Serhan Ozcan  3 , Mustafa Adem Tatlisu  2 , Ahmet Ilker Tekkesin  2 , Fatma Ozpamuk Karadeniz  4 , Gulay Gok  2 , Osman Kayapinar  1
Affiliations

Increased levels of red cell distribution width is correlated with presence of left atrial stasis in patients with non-valvular atrial fibrillation

Adnan Kaya et al. North Clin Istanb. .

Abstract

Objective: Red cell distribution width (RDW) and neutrophil to lymphocyte ratio (NLR) have been found to be associated with non-valvular atrial fibrillation (AF) and cardiovascular diseases. However, correlation of these parameters with presence of left atrial (LA) thrombus and/or spontaneous echo contrast (SEC) in patients with non-valvular AF has not been clarified. This study was an investigation of correlation of RDW, NLR, and clinical risk factors with LA thrombus and dense SEC in patients with non-valvular AF in the Turkish population.

Methods: The demographic, laboratory, and echocardiographic properties of 619 non-valvular AF patients who underwent transesophageal echocardiography (TEE) examination before direct current cardioversion (DCCV) or AF ablation treatment were retrospectively investigated. Complete blood count (CBC) and biochemical parameters were studied 6 to 12 hours before TEE examination. Left atrial stasis (LAS) markers were noted as presence of left atrial/left atrial appendage (LA/LAA) thrombus or dense spontaneous echo contrast (DSEC).

Results: Total of 325 (52%) patients with LAS were compared with 294 patients (48%) without LAS. In the LAS group, there were 274 (84%) patients with LA/LAA thrombus and 51 (16%) patients with DSEC. LAS (+) group, values for RDW (14.85±1.48 vs. 13.77±1.30; p<0.01), NLR (2.38 [1.58], vs. 2.10 [1.35]; p<0.01) and C-reactive protein (0.95 [0.61] vs. 0.88 [0.60] mg/L; p<0.01) were significantly higher than seen in LAS (-) group. In multivariate regression analysis, increased level of RDW, age, male gender, heart failure, duration of AF >6 months, and international normalized ratio <2 were independently correlated with presence of LAS.

Conclusion: Our study indicated that increased level of RDW is independently correlated with higher risk for development of LAS in patients with non-valvular AF.

Keywords: Left atrial thrombus; non-valvular atrial fibrillation; red cell distribution width.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

Figures

FIGURE 1
FIGURE 1
Box-plot graph demonstrating comparison of red cell distribution width level between the study groups. DSEC: Dense spontaneous echo contrast; LA: Left atrium; LAA: Left atrial appendage; LAS: Left atrial stasis.
FIGURE 2
FIGURE 2
Receiver operating characteristic curve analysis of red cell distribution width, neutrophil to lymphocyte ratio, and high sensitivity C-reactive protein level for prediction of left atrial stasis in the study population.
See this image and copyright information in PMC

References

    1. Morady F, Zipes DP. Atrial fibrillation:clinical features, mechanisms and management. In: Braunwald E, Libby P, Bonow RO, Mann DL, Zipes DP, editors. Braunwald’s heart disease. A textbook of cardiovascular medicine. 9th ed. Philadelphia, PA: WB Saunders Company; 2012. pp. 825–84.
    1. Khoo CW, Krishnamoorthy S, Lim HS, Lip GY. Atrial fibrillation, arrhythmia burden and thrombogenesis. Int J Cardiol. 2012;157:318–23. - PubMed
    1. Watson T, Shantsila E, Lip GY. Mechanisms of thrombogenesis in atrial fibrillation:Virchow’s triad revisited. Lancet. 2009;373:155–66. - PubMed
    1. Lappé JM, Horne BD, Shah SH, May HT, Muhlestein JB, Lappé DL, et al. Red cell distribution width, C-reactive protein, the complete blood count, and mortality in patients with coronary disease and a normal comparison population. Clin Chim Acta. 2011;412:2094–9. - PubMed
    1. Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJ, Pfeffer MA, et al. CHARM Investigators. Red cell distribution width as a novel prognostic marker in heart failure:data from the CHARM Program and the Duke Databank. J Am Coll Cardiol. 2007;50:40–7. - PubMed

LinkOut - more resources