PMID- 35621296 OWN - NLM STAT- MEDLINE DCOM- 20220719 LR - 20231130 IS - 1932-8737 (Electronic) IS - 0160-9289 (Print) IS - 0160-9289 (Linking) VI - 45 IP - 7 DP - 2022 Jul TI - Prognostic value of RDW alone and in combination with NT-proBNP in patients with heart failure. PG - 802-813 LID - 10.1002/clc.23850 [doi] AB - BACKGROUND: Red blood cell distribution width (RDW) and N-terminal pro brain natriuretic peptide (NT-proBNP) may predict the prognosis of heart failure (HF). However, the impact of combined RDW and NT-proBNP levels as a prognostic marker of HF remains unclear and the significance of this combination at various time-points has not been sufficiently studied. HYPOTHESIS: RDW can predict prognosis in HF at various time-points and combination with NT-proBNP improves the prognostic value. METHODS: Patients admitted to HF care unit of Fuwai Hospital CAMS&PUMC (Beijing, China) with a diagnosis of HF from November 2008 to November 2018 were analyzed retrospectively. RESULTS: In total, 3231 patients with available RDW data at admission were evaluated (median age 58 years, 71.9% males, 39.7% coronary heart disease, 68.6% New York Heart Association [NYHA] III or IV). Median RDW and NT-proBNP at admission were 13.4% (interquartile range [IQR]: 12.7%-14.5%), and 1723.00 pg/ml (IQR: 754.00-4006.25 pg/ml), respectively. During 2.9-year median follow-up, all-cause death occurred in 1075 (33.27%) patients. Kaplan-Meier survival curve and Cox proportional-hazard models, showed patients in the top quarter RDW had a 32.0% increased mortality compared to the bottom quarter (hazard ratio: 4.39, 95% confidence interval: 3.59-5.38; p <.001). The top quarter RDW retained independent prognostic value across HF with reduced ejection fraction [HFrEF], HF with mid-range ejection fraction [HFmrEF], and HF with preserved ejection fraction [HFpEF] subgroups. Patients were subsequently divided into four groups by median RDW and NT-proBNP. Comparison of Kaplan-Meier survival curves for various groups showed good risk stratification (p < .001). CONCLUSIONS: RDW is an independent predictor of mortality among patients with HF in the short-, medium-, and long-term. Combination of RDW and NT-proBNP improves the prognostic value. This is true across all clinical subtypes of heart failure (HFrEF, HFmrEF, HFpEF), and among most subgroups of patients with various comorbidities (infection, diabetes, hypertension). CI - (c) 2022 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC. FAU - Liang, Lin AU - Liang L AUID- ORCID: 0000-0002-7927-560X AD - State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China. FAU - Huang, Liyan AU - Huang L AUID- ORCID: 0000-0001-5967-2889 AD - State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China. FAU - Zhao, Xuemei AU - Zhao X AD - State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China. FAU - Zhao, Lang AU - Zhao L AUID- ORCID: 0000-0002-3927-2033 AD - State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China. FAU - Tian, Pengchao AU - Tian P AD - State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China. FAU - Huang, Boping AU - Huang B AUID- ORCID: 0000-0002-0086-8948 AD - State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China. FAU - Feng, Jiayu AU - Feng J AD - State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China. FAU - Zhang, Jian AU - Zhang J AD - State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China. AD - Key Laboratory of Clinical Research for Cardiovascular Medications, National Health Committee, Beijing, China. FAU - Zhang, Yuhui AU - Zhang Y AD - State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China. LA - eng GR - 2020-I2M-1-002/CAMS Innovation Fund for Medical Science/ GR - 2011BAI11B08/Key Projects in the National Science and Technology Pillar Program of the 12th Five-Year Plan Period/ GR - 2017YFC1308300/Key Projects in the National Science and Technology Pillar Program of the 13th Five-Year Plan Period/ GR - 81873472/National Nature Science Foundation of China/ PT - Journal Article DEP - 20220527 PL - United States TA - Clin Cardiol JT - Clinical cardiology JID - 7903272 RN - 0 (Biomarkers) RN - 0 (Peptide Fragments) RN - 0 (pro-brain natriuretic peptide (1-76)) RN - 114471-18-0 (Natriuretic Peptide, Brain) SB - IM CIN - Clin Cardiol. 2023 Jun;46(6):707. PMID: 37092770 MH - Biomarkers MH - Female MH - *Heart Failure MH - Humans MH - Male MH - Middle Aged MH - Natriuretic Peptide, Brain MH - Peptide Fragments MH - Prognosis MH - Retrospective Studies MH - Stroke Volume PMC - PMC9286336 OTO - NOTNLM OT - NT-proBNP OT - biomarkers OT - heart failure OT - prognosis OT - red cell distribution width COIS- The authors declare no conflict of interest. EDAT- 2022/05/28 06:00 MHDA- 2022/07/20 06:00 PMCR- 2022/05/27 CRDT- 2022/05/27 08:03 PHST- 2022/05/06 00:00 [revised] PHST- 2022/03/07 00:00 [received] PHST- 2022/05/16 00:00 [accepted] PHST- 2022/05/28 06:00 [pubmed] PHST- 2022/07/20 06:00 [medline] PHST- 2022/05/27 08:03 [entrez] PHST- 2022/05/27 00:00 [pmc-release] AID - CLC23850 [pii] AID - 10.1002/clc.23850 [doi] PST - ppublish SO - Clin Cardiol. 2022 Jul;45(7):802-813. doi: 10.1002/clc.23850. Epub 2022 May 27.