Elevated red cell distribution width and cardiovascular mortality in ASCVD risk cohorts: National Health and Nutrition Examination Survey (NHANES III)
Background: Although red cell distribution width (RDW) is associated with increased cardiovascular mortality, the relationship between an elevated RDW and cardiovascular mortality among various ASCVD risk groups is unknown. Methods: We utilized the National Health and Nutrition Examination Survey...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
IMR Press
2022-02-01
|
| Series: | Reviews in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://article.imrpress.com/journal/RCM/23/2/10.31083/j.rcm2302051/2153-8174-23-2-051.pdf |
| _version_ | 1819006043070398464 |
|---|---|
| author | Adarsh Katamreddy Damianos G Kokkinidis Jeremy Miles Gerasimos Siasos George Giannakoulas Robert T Faillace |
| author_facet | Adarsh Katamreddy Damianos G Kokkinidis Jeremy Miles Gerasimos Siasos George Giannakoulas Robert T Faillace |
| author_sort | Adarsh Katamreddy |
| collection | DOAJ |
| description | Background: Although red cell distribution width (RDW) is associated with
increased cardiovascular mortality, the relationship between an elevated RDW and
cardiovascular mortality among various ASCVD risk groups is unknown. Methods: We
utilized the National Health and Nutrition Examination Survey (NHANES) III, which
uses a complex, multistage, clustered design to represent the civilian,
community-based US population. Out of 30,818 subjects whose data were entered
during the 1988–1994 period, 8884 subjects over 40 years of age, representing a
weighted sample of 85,323,902 patients, were selected after excluding missing
variables. The ACC/AHA pooled cohort equation (PCE) was used to calculate
atherosclerotic cardiovascular disease (ASCVD) risk, and low (<7.5%),
intermediate (7.5–20%), and high (>20%) risk groups were created. The
primary endpoint was cardiovascular mortality. A multivariate proportional hazard
regression was performed using the Fine and Gray (sub-distribution) method. Red
cell distribution (RDW), C-reactive protein (CRP), age, sex, race, diabetes,
smoking status, high-density lipoprotein (HDL), and chronic kidney disease (CKD)
were used as covariates in each of the ACC/AHA pooled cohort risk groups.
Results: The adjusted hazard ratios for RDW >14 (Normal range 12.5–14.5 %) as
compared to <13 were 2.79 (95% confidence intervals (95% CI) 2.77–2.81,
p < 0.01), 2.02 (95% CI 2.01–2.02, p < 0.01), 1.18 (95%
CI 1.18–1.18, p < 0.01) in the low, intermediate and high-risk groups
respectively. The 20-year cumulative cardiovascular mortality (RDW >14 vs.
<13) was 4% vs. 1.3% low, 17.7% vs. 7.7% in intermediate and 28.1% vs.
24.6% in high ASCVD risk groups respectively. Conclusion: Our findings support
that measurement of RDW in the intermediate ASCVD group may be clinically
valuable for further risk stratification and prognostication in the general
population of people aged more than 40 years of age with regards to identifying
those at an increased risk for cardiovascular mortality. |
| first_indexed | 2024-12-21T00:02:24Z |
| format | Article |
| id | doaj.art-247fc474b8cf41279a33389346499e82 |
| institution | Directory Open Access Journal |
| issn | 1530-6550 |
| language | English |
| last_indexed | 2024-12-21T00:02:24Z |
| publishDate | 2022-02-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj.art-247fc474b8cf41279a33389346499e822022-12-21T19:22:35ZengIMR PressReviews in Cardiovascular Medicine1530-65502022-02-0123205110.31083/j.rcm2302051S1530-6550(22)00338-6Elevated red cell distribution width and cardiovascular mortality in ASCVD risk cohorts: National Health and Nutrition Examination Survey (NHANES III)Adarsh Katamreddy0Damianos G Kokkinidis1Jeremy Miles2Gerasimos Siasos3George Giannakoulas4Robert T Faillace5Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USADepartment of Medicine, Yale Univerisity School of Medicine, New Haven, CT 06510, USADepartment of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA1st Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, 15772 Athens, GreeceDivision of Cardiology, AHEPA University Hospital, Aristotle University School of Medicine, 55133 Thessaloniki, GreeceDepartment of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USABackground: Although red cell distribution width (RDW) is associated with increased cardiovascular mortality, the relationship between an elevated RDW and cardiovascular mortality among various ASCVD risk groups is unknown. Methods: We utilized the National Health and Nutrition Examination Survey (NHANES) III, which uses a complex, multistage, clustered design to represent the civilian, community-based US population. Out of 30,818 subjects whose data were entered during the 1988–1994 period, 8884 subjects over 40 years of age, representing a weighted sample of 85,323,902 patients, were selected after excluding missing variables. The ACC/AHA pooled cohort equation (PCE) was used to calculate atherosclerotic cardiovascular disease (ASCVD) risk, and low (<7.5%), intermediate (7.5–20%), and high (>20%) risk groups were created. The primary endpoint was cardiovascular mortality. A multivariate proportional hazard regression was performed using the Fine and Gray (sub-distribution) method. Red cell distribution (RDW), C-reactive protein (CRP), age, sex, race, diabetes, smoking status, high-density lipoprotein (HDL), and chronic kidney disease (CKD) were used as covariates in each of the ACC/AHA pooled cohort risk groups. Results: The adjusted hazard ratios for RDW >14 (Normal range 12.5–14.5 %) as compared to <13 were 2.79 (95% confidence intervals (95% CI) 2.77–2.81, p < 0.01), 2.02 (95% CI 2.01–2.02, p < 0.01), 1.18 (95% CI 1.18–1.18, p < 0.01) in the low, intermediate and high-risk groups respectively. The 20-year cumulative cardiovascular mortality (RDW >14 vs. <13) was 4% vs. 1.3% low, 17.7% vs. 7.7% in intermediate and 28.1% vs. 24.6% in high ASCVD risk groups respectively. Conclusion: Our findings support that measurement of RDW in the intermediate ASCVD group may be clinically valuable for further risk stratification and prognostication in the general population of people aged more than 40 years of age with regards to identifying those at an increased risk for cardiovascular mortality.https://article.imrpress.com/journal/RCM/23/2/10.31083/j.rcm2302051/2153-8174-23-2-051.pdfred cell distribution widthatherosclerotic cardiovascular disease (ascvd)cardiovascular prognosiscardiovascular mortality |
| spellingShingle | Adarsh Katamreddy Damianos G Kokkinidis Jeremy Miles Gerasimos Siasos George Giannakoulas Robert T Faillace Elevated red cell distribution width and cardiovascular mortality in ASCVD risk cohorts: National Health and Nutrition Examination Survey (NHANES III) Reviews in Cardiovascular Medicine red cell distribution width atherosclerotic cardiovascular disease (ascvd) cardiovascular prognosis cardiovascular mortality |
| title | Elevated red cell distribution width and cardiovascular mortality in ASCVD risk cohorts: National Health and Nutrition Examination Survey (NHANES III) |
| title_full | Elevated red cell distribution width and cardiovascular mortality in ASCVD risk cohorts: National Health and Nutrition Examination Survey (NHANES III) |
| title_fullStr | Elevated red cell distribution width and cardiovascular mortality in ASCVD risk cohorts: National Health and Nutrition Examination Survey (NHANES III) |
| title_full_unstemmed | Elevated red cell distribution width and cardiovascular mortality in ASCVD risk cohorts: National Health and Nutrition Examination Survey (NHANES III) |
| title_short | Elevated red cell distribution width and cardiovascular mortality in ASCVD risk cohorts: National Health and Nutrition Examination Survey (NHANES III) |
| title_sort | elevated red cell distribution width and cardiovascular mortality in ascvd risk cohorts national health and nutrition examination survey nhanes iii |
| topic | red cell distribution width atherosclerotic cardiovascular disease (ascvd) cardiovascular prognosis cardiovascular mortality |
| url | https://article.imrpress.com/journal/RCM/23/2/10.31083/j.rcm2302051/2153-8174-23-2-051.pdf |
| work_keys_str_mv | AT adarshkatamreddy elevatedredcelldistributionwidthandcardiovascularmortalityinascvdriskcohortsnationalhealthandnutritionexaminationsurveynhanesiii AT damianosgkokkinidis elevatedredcelldistributionwidthandcardiovascularmortalityinascvdriskcohortsnationalhealthandnutritionexaminationsurveynhanesiii AT jeremymiles elevatedredcelldistributionwidthandcardiovascularmortalityinascvdriskcohortsnationalhealthandnutritionexaminationsurveynhanesiii AT gerasimossiasos elevatedredcelldistributionwidthandcardiovascularmortalityinascvdriskcohortsnationalhealthandnutritionexaminationsurveynhanesiii AT georgegiannakoulas elevatedredcelldistributionwidthandcardiovascularmortalityinascvdriskcohortsnationalhealthandnutritionexaminationsurveynhanesiii AT roberttfaillace elevatedredcelldistributionwidthandcardiovascularmortalityinascvdriskcohortsnationalhealthandnutritionexaminationsurveynhanesiii |