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. 2021 Sep 26;13(9):503-513.
doi: 10.4330/wjc.v13.i9.503.

Red blood cell distribution width in elderly hospitalized patients with cardiovascular disease

Andrew Xanthopoulos  1 , Konstantinos Tryposkiadis  2 , Apostolos Dimos  3 , Angeliki Bourazana  3 , Alexandros Zagouras  3 , Nikolaos Iakovis  3 , Michail Papamichalis  3 , Grigorios Giamouzis  3 , George Vassilopoulos  4 , John Skoularigis  3 , Filippos Triposkiadis  3
Affiliations

Red blood cell distribution width in elderly hospitalized patients with cardiovascular disease

Andrew Xanthopoulos et al. World J Cardiol. .

Abstract

Background: Red blood cell distribution width (RDW) is elevated in patients with cardiovascular disease (CVD).

Aim: To determine RDW values and impact of CV and non-CV coexisting morbidities in elderly patients hospitalized with chronic CVD.

Methods: This prospective study included 204 consecutive elderly patients (age 77.5 [7.41] years, female 94 [46%], left ventricular ejection fraction 53.00% [37.50, 55.00]) hospitalized with chronic CVD at the Cardiology Department of Larissa University General Hospital (Larissa, Greece) from January 2019 to April 2019. Elderly patients were selected due to the high prevalence of coexisting morbidities in this patient population. Hospitalized patients with acute CVD (acute coronary syndromes, new-onset heart failure [HF], and acute pericarditis/myocarditis), primary isolated valvular heart disease, sepsis, and those with a history of blood transfusions or cancer were excluded. The evaluation of the patients within 24 h from admission included clinical examination, laboratory blood tests, and echocardiography.

Results: The most common cardiac morbidities were hypertension and coronary artery disease, with acutely decompensated chronic heart failure (ADCHF) and atrial fibrillation (AF) also frequently being present. The most common non-cardiac morbidities were anemia and chronic kidney disease followed by diabetes mellitus, chronic obstructive pulmonary disease, and sleep apnea. RDW was significantly elevated 15.48 (2.15); 121 (59.3%) of patients had RDW > 14.5% which represents the upper limit of normal in our institution. Factors associated with RDW in stepwise regression analysis were ADCHF (coefficient: 1.406; 95% confidence interval [CI]: 0.830-1.981; P < 0.001), AF (1.192; 0.673 to 1.711; P < 0.001), and anemia (0.806; 0.256 to 1.355; P = 0.004). ADCHF was the most significant factor associated with RDW. RDW was on average 1.41 higher for patients with than without ADCHF, 1.19 higher for patients with than without AF, and 0.81 higher for patients with than without anemia. When patients were grouped based on the presence or absence of anemia, ADCHF and AF, heart rate was not increased in those with anemia but was significantly increased in those with ADCHF or AF.

Conclusion: RDW was elevated in elderly hospitalized patients with chronic CVD. Factors associated with RDW were anemia and CV factors associated with elevated heart rate (ADCHF, AF), suggesting sympathetic overactivity.

Keywords: Cardiovascular disease; Coexisting morbidities; Elderly; Red blood cell distribution width.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflict of interest regarding the present work

Figures

Figure 1
Figure 1
Heart rate in the presence or absence of anemia, acutely decompensated chronic heart failure, and atrial fibrillation. ADCHF: Acutely decompensated chronic heart failure; bpm: Beats per minute.
See this image and copyright information in PMC

References

    1. Bazick HS, Chang D, Mahadevappa K, Gibbons FK, Christopher KB. Red cell distribution width and all-cause mortality in critically ill patients. Crit Care Med. 2011;39:1913–1921. - PMC - PubMed
    1. Danese E, Lippi G, Montagnana M. Red blood cell distribution width and cardiovascular diseases. J Thorac Dis. 2015;7:E402–E411. - PMC - PubMed
    1. Xanthopoulos A, Giamouzis G, Melidonis A, Kitai T, Paraskevopoulou E, Paraskevopoulou P, Patsilinakos S, Triposkiadis F, Skoularigis J. Red blood cell distribution width as a prognostic marker in patients with heart failure and diabetes mellitus. Cardiovasc Diabetol. 2017;16:81. - PMC - PubMed
    1. Pearson-Stuttard J, Ezzati M, Gregg EW. Multimorbidity-a defining challenge for health systems. Lancet Public Health. 2019;4:e599–e600. - PubMed
    1. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015;16:233–270. - PubMed