• Miryam Olivares Jara, Enrique Santas Olmeda, Gema Miñana Escrivà, Patricia Palau Sampio, Pilar Merlos Díaz, Juan Sanchis Forés, and Julio Núñez Villota.
• Servicio de Cardiología, Hospital Clínico Universitario de Valencia, INCLIVA, Universidad de Valencia, Valencia, España. miryam_olivares@hotmail.com
• Med Clin (Barc). 2013 May 13; 140 (10): 433-8.

Background And ObjectiveRed cell distribution width (RDW) is a quantitative measure of the variability in size of erythrocytes, and it is used for the differential diagnosis of anemia. Recent reports have suggested that high RDW could play a role for risk stratification in patients with chronic heart failure. However, the prognostic role of RDW in unselected population with acute heart failure (AHF), after a thoroughly multivariate adjustment, has not been well established. The aim of this study was to establish the association between RDW and long-term mortality in patients admitted for AHF.Patients And MethodWe analyzed 1,190 consecutive patients admitted for AHF in our center. RDW measurement was performed on admission. RDW values were stratified into quartiles (Q) and the association of RDW with total mortality was assessed using Cox regression.ResultsAfter a median follow-up of 15 months (interquartile range 3-33 months) 458 (38%) deaths were identified. There was a progressive increase in mortality rates from Q1 to Q4: 1.34, 1.82, 2.56 and 3.53 per 10 patients-year of follow-up (for Q1, Q2, Q3 and Q4 respectively, P for trend <.001). In the multivariate analysis, this association remained independent for patients in Q3 (15-16%) and Q4 (>16%) versus Q1 (≤14%), hazard ratio (HR): 1.66, 95% confidence interval (95% CI) 1.24-2.22, P<.01, HR: 1.80, 95% CI 1.33-2.43, p<.01, respectively, in a model adjusted for established prognostic markers in AHF.ConclusionIn patients with AHF, higher RDW values were associated with increased long-term mortality.Copyright © 2012 Elsevier España, S.L. All rights reserved.

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