American Heart Journal
Volume 158, Issue 4 , Pages 659-666 , October 2009

Red cell distribution width in heart failure: Prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state

  • Zsolt Förhécz, MD

      Affiliations

    • 3rd Department of Internal Medicine, and Szentágothai Knowledge Center, Semmelweis University, Budapest, Hungary
    • ,
  • Tímea Gombos, MD

      Affiliations

    • 3rd Department of Internal Medicine, and Szentágothai Knowledge Center, Semmelweis University, Budapest, Hungary
    • ,
  • Gábor Borgulya, MD, MSc

      Affiliations

    • Research Group of Inflammation Biology and Immunogenomics, Hungarian Academy of Sciences, Budapest, Hungary
    • ,
  • Zoltán Pozsonyi, MD

      Affiliations

    • 3rd Department of Internal Medicine, and Szentágothai Knowledge Center, Semmelweis University, Budapest, Hungary
    • ,
  • Zoltán Prohászka, MD, DSc

      Affiliations

    • 3rd Department of Internal Medicine, and Szentágothai Knowledge Center, Semmelweis University, Budapest, Hungary
    • Research Group of Inflammation Biology and Immunogenomics, Hungarian Academy of Sciences, Budapest, Hungary
    • Corresponding Author InformationReprint requests: Zoltán Prohászka, MD, DSc, 3rd Department of Internal Medicine, Semmelweis University, Research Laboratory, Budapest 1125, Hungary.
    • ,
  • Lívia Jánoskuti, MD, PhD

      Affiliations

    • 3rd Department of Internal Medicine, and Szentágothai Knowledge Center, Semmelweis University, Budapest, Hungary

Received 30 April 2009 ,Accepted 10 July 2009.

References 

  1. Morris M, Davey FR. Basic examination of blood. In:  Henry JB editors. Clinical diagnosis and management by laboratory methods, 20th Edition. Philadelphia: W.B. Saunders Company; 2001;
  2. Demir A, Yarali N, Fisgin T, et al. Most reliable indices in differentiation between thalassemia trait and iron deficiency anemia. Pediatr Int. 2002;44:612–616
  3. van Zeben D, Bieger R, van Wermeskerken RK, et al. Evaluation of microcytosis using serum ferritin and red blood cell distribution width. Eur J Haematol. 1990;44:106–109
  4. Aslan D, Gumruk F, Gurgey A, et al. Importance of RDW value in differential diagnosis of hypochrome anemias. Am J Hematol. 2002;69:31–33
  5. Akarsu S, Taskin E, Yilmaz E, et al. Treatment of iron deficiency anemia with intravenous iron preparations. Acta Haematol. 2006;116:51–57
  6. Go AS, Yang J, Ackerson LM, et al. Hemoglobin level, chronic kidney disease, and the risks of death and hospitalization in adults with chronic heart failure: the Anemia in Chronic Heart Failure: Outcomes and Resource Utilization (ANCHOR) Study. Circulation. 2006;113:2713–2723
  7. Muzzarelli S, Pfisterer M. Anemia as independent predictor of major events in elderly patients with chronic angina. Am Heart J. 2006;152:991–996
  8. Sabatine MS, Morrow DA, Giugliano RP, et al. Association of hemoglobin levels with clinical outcomes in acute coronary syndromes. Circulation. 2005;111:2042–2049
  9. Felker GM, Allen LA, Pocock SJ, et al. 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;50:40–47
  10. Tonelli M, Sacks F, Arnold M, et al. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation. 2008;117:163–168
  11. Ani C, Ovbiagele B. Elevated red blood cell distribution width predicts mortality in persons with known stroke. J Neurol Sci. 2009;277:103–108
  12. Cavusoglu E, Chopra V, Gupta A, et al. Relation between red blood cell distribution width (RDW) and all-cause mortality at two years in an unselected population referred for coronary angiography. Int J Cardiol. 2009;
  13. Felker GM, Adams KF, Gattis WA, et al. Anemia as a risk factor and therapeutic target in heart failure. J Am Coll Cardiol. 2004;44:959–966
  14. Das Gupta A, Hegde C, Mistri R. Red cell distribution width as a measure of severity of iron deficiency in iron deficiency anaemia. Indian J Med Res. 1994;100:177–183
  15. Das Gupta A, Abbi A. High serum transferrin receptor level in anemia of chronic disorders indicates coexistent iron deficiency. Am J Hematol. 2003;72:158–161
  16. Maury CP, Andersson LC, Teppo AM, et al. Mechanism of anaemia in rheumatoid arthritis: demonstration of raised interleukin 1 beta concentrations in anaemic patients and of interleukin 1 mediated suppression of normal erythropoiesis and proliferation of human erythroleukaemia (HEL) cells in vitro. Ann Rheum Dis. 1988;47:972–978
  17. Papadaki HA, Kritikos HD, Valatas V, et al. Anemia of chronic disease in rheumatoid arthritis is associated with increased apoptosis of bone marrow erythroid cells: improvement following anti-tumor necrosis factor-alpha antibody therapy. Blood. 2002;100:474–482
  18. Vreugdenhil G, Lowenberg B, Van Eijk HG, et al. Tumor necrosis factor alpha is associated with disease activity and the degree of anemia in patients with rheumatoid arthritis. Eur J Clin Invest. 1992;22:488–493
  19. Gabrilove JL. Introduction and overview of hematopoietic growth factors. Semin Hematol. 1989;26(2 Suppl 2):1–4
  20. Jelkmann WE, Fandrey J, Frede S, et al. Inhibition of erythropoietin production by cytokines. Implications for the anemia involved in inflammatory states. Ann N Y Acad Sci. 1994;718:300–309[discussion 309-11]
  21. Lacombe C, Mayeux P. The molecular biology of erythropoietin. Nephrol Dial Transplant. 1999;14(Suppl 2):22–28
  22. Macdougall IC, Cooper A. The inflammatory response and epoetin sensitivity. Nephrol Dial Transplant. 2002;17(Suppl 1):48–52
  23. Levine B, Kalman J, Mayer L, et al. Elevated circulating levels of tumor necrosis factor in severe chronic heart failure. N Engl J Med. 1990;323:236–241
  24. Munger MA, Johnson B, Amber IJ, et al. Circulating concentrations of proinflammatory cytokines in mild or moderate heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol. 1996;77:723–727
  25. Deswal A, Petersen NJ, Feldman AM, et al. Cytokines and cytokine receptors in advanced heart failure: an analysis of the cytokine database from the Vesnarinone trial (VEST). Circulation. 2001;103:2055–2059
  26. Chiari MM, Bagnoli R, De Luca PD, et al. Influence of acute inflammation on iron and nutritional status indexes in older inpatients. J Am Geriatr Soc. 1995;43:767–771
  27. Pierce CN, Larson DF. Inflammatory cytokine inhibition of erythropoiesis in patients implanted with a mechanical circulatory assist device. Perfusion. 2005;20:83–90
  28. Horwich TB, Hamilton MA, Maclellan WR, et al. Low serum total cholesterol is associated with marked increase in mortality in advanced heart failure. J Card Fail. 2002;8:216–224
  29. Kalantar-Zadeh K, Anker SD, Horwich TB, et al. Nutritional and anti-inflammatory interventions in chronic heart failure. Am J Cardiol. 2008;101:89E–103E

PII: S0002-8703(09)00551-1

doi: 10.1016/j.ahj.2009.07.024

American Heart Journal
Volume 158, Issue 4 , Pages 659-666 , October 2009

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