Red cell distribution width predicts new-onset atrial fibrillation in sepsis patients

Background: The use of the CHA2DS2-VASc scoring system and red cell distribution width (RDW) as post-op Atrial Fibrillation (POAF) predictors may be promising for the identification of patients that are at a higher risk of POAF.Methods: A total of 358 patients (57 patients with POAF, and 301 patients with non-POAF ) with sinus rhythm undergoing a coronary artery bypass graft (CABG) operation were included in the study retrospectively. Preoperative RDW levels and electrocardiograms with sinus rhythm were recorded. Patients with at least one 12-lead electrocardiogram with atrial fibrillation in the postoperative period, with or without medical or electrical cardioversion, were considered to have postoperative atrial fibrillation. A CHADS2 and CHA2DS2-VASc score was calculated for all of the patients.Results: RDW levels were significantly higher in POAF group. RDW levels were significantly correlated with CHADS2 ( r = 0.15, P = .007) and CHA2DS2-VASc (r = 0.19 P = .0001) scores. CHA2DS2-VASc scores were significantly higher in patients with POAF, whereas CHADS2 scores did not differ between groups. In multivariate analysis, left atrial diameter (LAD) (OR:2.44 [95% CI 1.16 – 5.1], P = .018), age (OR:1.04 [95% CI 1.01 – 1.08], P = .01), and RDW (OR:1.16 [95% CI 1.0 – 1.36], P = .05) were found to be predictive for POAF. The area under the receiver-operating characteristic curve of RDW was 0.65 (0.57 – 0.72, P = .0001) with 68.4% sensitivity and 51.2 % specificity to predict POAF.Conclusion: Our study showed that age, LAD, and the reduced probability of RDW are predictors of POAF, and that RDW is strongly associated with the thromboembolic risk as determined by CHADS2 and CHA2DS2-VASc scores.

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Abstract 090: Outcomes of Hypertensive Crises as Predicted by Red Cell Distribution Width

Hypertension ◽

10.1161/hyp.66.suppl_1.090 ◽

2015 ◽

Vol 66 (suppl_1) ◽

Author(s):

Suraj Raheja ◽

Kush Patel ◽

Ruchir Patel ◽

Sagger Mawri ◽

Alexander Michaels ◽

...

Keyword(s):

Heart Failure ◽

Independent Predictor ◽

Hypertensive Crisis ◽

Red Cell Distribution Width ◽

Categorical Variables ◽

Red Cell ◽

Cell Distribution ◽

Distribution Width ◽

All Cause Mortality ◽

New Onset

Background: Red cell distribution width (RDW) is a measure of the variability in size of erythrocytes. A high RDW value indicates greater variation in size between individual erythrocytes and has been shown to be an independent predictor of mortality in patients with coronary artery disease, heart failure and in patients undergoing percutaneous coronary intervention (PCI). The aim of this study was to evaluate the prognostic value of RDW in predicting clinical outcomes in patients with hypertensive crisis. Methods: We performed a retrospective study of 465 consecutive patients from January 2007 to March 2010 who presented with hypertensive crisis. Hypertensive crisis was defined as systolic BP >180 and/or diastolic BP >110mmHg with impending or progressive end organ dysfunction requiring inpatient hospitalization. The study sample consisted of 465 patients (38.9% men (181 of 465); mean age 59.6 ± 15.9). Baseline levels of RDW were measured at time of admission and analyzed as continuous and categorical variables (elevated RDW was defined as >14.5%). Multivariable regression analysis was performed for development of all-cause mortality, myocardial infarction, new-onset heart failure (defined as first time hospital admission for heart failure), stroke and MACE (MI, new-onset heart failure and stroke) at 2 years. Results: RDW > 14.5% was a strong independent predictor of all-cause mortality at 2 years (OR: 1.90, 95% CI: 1.1-3.3, p <0.05). Elevated RDW was also found to be an independent predictor of new-onset heart failure at 2 years (OR: 1.97, 95% CI: 1.1-3.7, p <0.05). Elevated RDW was not a predictor of MI, PCI or stroke at 2 years. Conclusions: Elevated RDW level in patients with hypertensive crisis was an independent predictor of all-cause mortality and new-onset heart failure in patients with hypertensive crisis.

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