Red blood cell distribution width (RDW) is associated with unfavorable functional outcome after transfemoral transcatheter aortic valve implantation
Background: Red blood cell distribution width (RDW) is calculated in every blood count test and reflects variability in erythrocyte size. High levels mirror dysregulated erythrocyte homeostasis and have been associated with clonal hematopoiesis as well as higher mortality in several conditions.We ai...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906724000496 |
| _version_ | 1827289756716761088 |
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| author | Georg Stachel Madlen Jentzsch Michelle Oehring Marios Antoniadis Sebastian Schwind Thilo Noack Uwe Platzbecker Michael Borger Ulrich Laufs Karsten Lenk |
| author_facet | Georg Stachel Madlen Jentzsch Michelle Oehring Marios Antoniadis Sebastian Schwind Thilo Noack Uwe Platzbecker Michael Borger Ulrich Laufs Karsten Lenk |
| author_sort | Georg Stachel |
| collection | DOAJ |
| description | Background: Red blood cell distribution width (RDW) is calculated in every blood count test and reflects variability in erythrocyte size. High levels mirror dysregulated erythrocyte homeostasis and have been associated with clonal hematopoiesis as well as higher mortality in several conditions.We aimed to determine the impact of preprocedural RDW levels on functional outcomes after transcatheter aortic valve implantation (TAVI). Methods: In this single-center retrospective study, we analyzed 176 consecutive patients receiving TAVI between 2017 and 2021. RDW upper limit of normal was < 15 %. Patients were stratified according to preprocedural RDW as having normal or elevated values. We assessed all-cause-mortality and a composite endpoint comprising cardiovascular/ valve-related mortality and cardiovascular, valve-related and heart failure hospitalization at 1 year. Results: 43 patients (24.4 %) had RDW ≥ 15 %. There were significant baseline differences between groups (Society of Thoracic Surgeons – Predicted Risk of Mortality score 3.18 %[interquartile range 1.87–5.47] vs. 6.63 %[4.12–10.54] p < 0.001; hemoglobin 13.2 g/dL[11.8–14.1] vs. 10.4 g/dL[9.8–12.2], p < 0.001, RDW-normal vs. RDW-high, respectively). Age was not distinct (80.2 years [77.5–84.1] vs 81.2[71.3–84.7], p = 0.78). 1-year-all-cause mortality was not different (7.9 % vs. 9.4 %, p = 0.79). The RDW-high group showed markedly higher NT-proBNP levels after 1 year (647 ng/ml[283–1265] vs. 1893 ng/ml[744–5109], p = 0.005), and experienced more clinical endpoints (hazard ratio 2.57[1.28–5.16] for the composite endpoint, p = 0.006). RDW remained an independent predictor of the composite endpoint when accounting for all baseline differences in multivariable regression. Conclusion: Elevated preprocedural RDW identifies patients at risk for impaired functional outcome after TAVI and may represent a useful low-cost parameter to guide intensity of outpatient surveillance strategies. |
| first_indexed | 2024-04-24T11:56:31Z |
| format | Article |
| id | doaj.art-6d0be105e6d241549f84a520ad845743 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-04-24T11:56:31Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-6d0be105e6d241549f84a520ad8457432024-04-09T04:13:18ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672024-04-0151101383Red blood cell distribution width (RDW) is associated with unfavorable functional outcome after transfemoral transcatheter aortic valve implantationGeorg Stachel0Madlen Jentzsch1Michelle Oehring2Marios Antoniadis3Sebastian Schwind4Thilo Noack5Uwe Platzbecker6Michael Borger7Ulrich Laufs8Karsten Lenk9Medical Clinic and Policlinic IV - Cardiology, University of Leipzig Medical Center, Leipzig, Germany; Corresponding author at: Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103 Leipzig, Germany.Medical Clinic and Policlinic I - Hematology, Cell Therapy and Hemostaseology, University of Leipzig Medical Center, Leipzig, GermanyMedical Clinic and Policlinic IV - Cardiology, University of Leipzig Medical Center, Leipzig, GermanyMedical Clinic and Policlinic IV - Cardiology, University of Leipzig Medical Center, Leipzig, GermanyMedical Clinic and Policlinic I - Hematology, Cell Therapy and Hemostaseology, University of Leipzig Medical Center, Leipzig, GermanyUniversity Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, GermanyMedical Clinic and Policlinic I - Hematology, Cell Therapy and Hemostaseology, University of Leipzig Medical Center, Leipzig, GermanyUniversity Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, GermanyMedical Clinic and Policlinic IV - Cardiology, University of Leipzig Medical Center, Leipzig, GermanyMedical Clinic and Policlinic IV - Cardiology, University of Leipzig Medical Center, Leipzig, GermanyBackground: Red blood cell distribution width (RDW) is calculated in every blood count test and reflects variability in erythrocyte size. High levels mirror dysregulated erythrocyte homeostasis and have been associated with clonal hematopoiesis as well as higher mortality in several conditions.We aimed to determine the impact of preprocedural RDW levels on functional outcomes after transcatheter aortic valve implantation (TAVI). Methods: In this single-center retrospective study, we analyzed 176 consecutive patients receiving TAVI between 2017 and 2021. RDW upper limit of normal was < 15 %. Patients were stratified according to preprocedural RDW as having normal or elevated values. We assessed all-cause-mortality and a composite endpoint comprising cardiovascular/ valve-related mortality and cardiovascular, valve-related and heart failure hospitalization at 1 year. Results: 43 patients (24.4 %) had RDW ≥ 15 %. There were significant baseline differences between groups (Society of Thoracic Surgeons – Predicted Risk of Mortality score 3.18 %[interquartile range 1.87–5.47] vs. 6.63 %[4.12–10.54] p < 0.001; hemoglobin 13.2 g/dL[11.8–14.1] vs. 10.4 g/dL[9.8–12.2], p < 0.001, RDW-normal vs. RDW-high, respectively). Age was not distinct (80.2 years [77.5–84.1] vs 81.2[71.3–84.7], p = 0.78). 1-year-all-cause mortality was not different (7.9 % vs. 9.4 %, p = 0.79). The RDW-high group showed markedly higher NT-proBNP levels after 1 year (647 ng/ml[283–1265] vs. 1893 ng/ml[744–5109], p = 0.005), and experienced more clinical endpoints (hazard ratio 2.57[1.28–5.16] for the composite endpoint, p = 0.006). RDW remained an independent predictor of the composite endpoint when accounting for all baseline differences in multivariable regression. Conclusion: Elevated preprocedural RDW identifies patients at risk for impaired functional outcome after TAVI and may represent a useful low-cost parameter to guide intensity of outpatient surveillance strategies.http://www.sciencedirect.com/science/article/pii/S2352906724000496Aortic stenosisTranscatheter Aortic Valve ImplantationRDWCHIP |
| spellingShingle | Georg Stachel Madlen Jentzsch Michelle Oehring Marios Antoniadis Sebastian Schwind Thilo Noack Uwe Platzbecker Michael Borger Ulrich Laufs Karsten Lenk Red blood cell distribution width (RDW) is associated with unfavorable functional outcome after transfemoral transcatheter aortic valve implantation International Journal of Cardiology: Heart & Vasculature Aortic stenosis Transcatheter Aortic Valve Implantation RDW CHIP |
| title | Red blood cell distribution width (RDW) is associated with unfavorable functional outcome after transfemoral transcatheter aortic valve implantation |
| title_full | Red blood cell distribution width (RDW) is associated with unfavorable functional outcome after transfemoral transcatheter aortic valve implantation |
| title_fullStr | Red blood cell distribution width (RDW) is associated with unfavorable functional outcome after transfemoral transcatheter aortic valve implantation |
| title_full_unstemmed | Red blood cell distribution width (RDW) is associated with unfavorable functional outcome after transfemoral transcatheter aortic valve implantation |
| title_short | Red blood cell distribution width (RDW) is associated with unfavorable functional outcome after transfemoral transcatheter aortic valve implantation |
| title_sort | red blood cell distribution width rdw is associated with unfavorable functional outcome after transfemoral transcatheter aortic valve implantation |
| topic | Aortic stenosis Transcatheter Aortic Valve Implantation RDW CHIP |
| url | http://www.sciencedirect.com/science/article/pii/S2352906724000496 |
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