scholarly journals High Red Cell Distribution Width and Low Absolute Lymphocyte Count Associate With Subsequent Mortality in HCV Infection

2021 ◽  
Vol 6 (2) ◽  
pp. 90-104
Author(s):  
Sofi Damjanovska ◽  
Perica Davitkov ◽  
Surya Gopal ◽  
Lenche Kostadinova ◽  
Corrine Kowal ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Liver Disease ◽  
Lymphocyte Count ◽  
Transient Elastography ◽  
Absolute Lymphocyte Count ◽  
Hcv Infection ◽  
Red Cell Distribution Width ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width

Background: Hepatitis-C virus (HCV) chronic infection can lead to cirrhosis, hepatocellular carcinoma (HCC), end-stage liver disease, cardiovascular disease (CVD), and mortality. Transient Elastography (TE) is used to non-invasively assess fibrosis. Whether immune monitoring provides additive prognostic value is not established. Increased red-cell distribution width (RDW) and decreased absolute lymphocyte count (ALC) predict mortality in those without liver disease. Whether these relationships remain during HCV infection is unknown.  Materials and Methods: A retrospective cohort of 1,715 single-site VA Liver Clinic patients receiving Transient Elastography (TE) 2014-2019 to evaluate HCV-associated liver damage were evaluated for RDW and ALC in relation to traditional parameters of cardiovascular risk, liver health, development of HCC, and mortality. Results: The cohort was 97% male, 55% African American, 26% with diabetes mellitus, 67% with hypertension, and 66% with tobacco use. After TE, 3% were subsequently diagnosed with HCC, and 12% (n=208) died. Most deaths (n=189) were due to non-liver causes. The TE score associated with prevalent CVD positively correlated with atherosclerotic cardiovascular disease (ASCVD) 10-Year Risk Score, age, RDW, and negatively correlated with ALC. Patients with anisocytosis (RDW above 14%) or lymphopenia (ALC level under 1.2x109/L) had greater subsequent all-cause mortality, even after adjusting for age, TE score, and comorbidities. TE score, and to a modest degree RDW, were associated with subsequent liver-associated mortality, while TE score, RDW, and ALC were each independently associated with non-liver cause of death. Conclusion: Widely available mortality calculators generally require multiple pieces of clinical information. RDW and ALC, parameters collected on a single laboratory test that is commonly performed, prior to HCV therapy may be pragmatic markers of long-term risk of mortality. 

scholarly journals Could ratio of hemoglobin to red cell distribution width and ratio of absolute lymphocyte count to absolute monocyte count be a prognostic tool in newly diagnosed multiple myeloma patients?

2020 ◽  
Vol 51 (2) ◽  
pp. 81-87
Author(s):  
Mehmet Baysal ◽  
Ufuk Demirci ◽  
Volkan Bas ◽  
Sedanur Karaman Gulsaran ◽  
Elif Umit ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Lymphocyte Count ◽  
Absolute Lymphocyte Count ◽  
Red Cell Distribution Width ◽  
Monocyte Count ◽  
Red Cell ◽  
Cell Distribution ◽  
Newly Diagnosed ◽  
Distribution Width ◽  
Cutoff Value

AbstractIntroductionHemoglobin/red cell distribution width (RDW) ratio (HRR) and lymphocyte-to-monocyte ratio (LMR) are two novel bio-markers associated with overall survival (OS) and prognosis in several types of cancers. The aim of this study is to investigate the value of HRR and LMR in newly diagnosed multiple myeloma (MM) patients.MethodsA total of 180 patients were included in this study. Patients diagnosed with MM between May 2013 and May 2019 at a single center were evaluated. HRR was calculated by dividing hemoglobin to RDW, both measured from the same sample. LMR was calculated by dividing absolute lymphocyte count (ALC) to absolute monocyte count (AMC).ResultsThe cutoff value for HRR was taken as 0.61, and the cutoff value for LMR was taken as 3.28. Patients were divided into low HRR, high HRR, low LMR, and high LMR groups. OS of the patients with low HRR was found lower compared with high HRR (36.7 months for low HRR and 53.2 months for high HRR, p < 0.001). Also, OS was found lower in the low LMR group (39.4 months for low LMR and 51.7 months for high LMR, p = 0.016). On multivariate analysis, low HRR and low LMR were predictive factors of OS (hazard ratio (HR) 2.08, 95% confidence intervals (CI) 1.31–3.03, and p = 0.002 for low HRR; HR 1.47, 95% CI 0.92–2.29, and p = 0.010 for low LMR).ConclusionCombining both HRR and LMR could be a prognostic biomarker and it reflects the status of the immune system in newly diagnosed MM patients.

scholarly journals The diagnostic and prognostic value of red cell distribution width in cardiovascular disease; current status and prospective

BioFactors ◽  
2019 ◽  
Author(s):  
Seyed M. Parizadeh ◽  
Reza Jafarzadeh‐Esfehani ◽  
Amirhossein Bahreyni ◽  
Maryam Ghandehari ◽  
Mojtaba Shafiee ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Prognostic Value ◽  
Red Cell Distribution Width ◽  
Current Status ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Diagnostic And Prognostic Value

scholarly journals Is Red Cell Distribution Width a Marker for the Presence and Poor Prognosis of Cardiovascular Disease?

2012 ◽  
Vol 44 (3) ◽  
pp. 169-171 ◽  
Author(s):  
Turgay Isik ◽  
Erkan Ayhan ◽  
Ibrahim Halil Tanboga ◽  
Ahmet Kaya ◽  
Enbiya Aksakal ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Poor Prognosis ◽  
Red Cell Distribution Width ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width

scholarly journals Impact of Chronic Inflammation, Assessed by hs-CRP, on the Association between Red Cell Distribution Width and Arterial Cardiovascular Disease: The Tromsø Study

TH Open ◽  
2018 ◽  
Vol 02 (02) ◽  
pp. e182-e189 ◽  
Author(s):  
Jostein Lappegård ◽  
Trygve Ellingsen ◽  
Kristian Hindberg ◽  
Ellisiv Mathiesen ◽  
Inger Njølstad ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Ischemic Stroke ◽  
Chronic Inflammation ◽  
Red Cell Distribution Width ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Causal Pathway ◽  
Hs Crp ◽  
The Impact

AbstractRed cell distribution width (RDW), a measure of variability in size of circulating erythrocytes, is associated with arterial cardiovascular disease (CVD), but the underlying mechanism remains unclear. We aimed to investigate the impact of chronic inflammation as measured by high-sensitivity C-reactive protein (hs-CRP) on this relationship, and explore whether RDW could be a mediator in the causal pathway between inflammation and arterial CVD. Baseline characteristics, including RDW and hs-CRP, were obtained from 5,765 individuals attending a population-based cohort study. We followed up participants from inclusion in the fourth survey of the Tromsø Study (1994/1995) until December 31, 2012. Multivariable Cox-regression models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI) for incident myocardial infarction (MI) and ischemic stroke across quintiles of hs-CRP and RDW. Subjects with hs-CRP in the highest quintile had 44% higher risk of MI (HR: 1.44, 95% CI: 1.14–1.80), and 64% higher risk of ischemic stroke (HR: 1.64, 95% CI: 1.20–2.24) compared with subjects in the lowest quintile. RDW mediated 7.2% (95% CI: 4.0–30.8%) of the association between hs-CRP and ischemic stroke. Subjects with RDW in the highest quintile had 22% higher risk of MI (HR: 1.22, 95% CI: 0.98–1.54) and 44% higher risk of ischemic stroke (HR: 1.44, 95% CI: 1.06–1.97) compared with subjects in the lowest quintile. These risk estimates were slightly attenuated after adjustments for hs-CRP. Our findings suggest that chronic inflammation is not a primary mechanism underlying the relationship between RDW and arterial CVD.

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