Xanthopoulos A, Tryposkiadis K, Dimos A, Bourazana A, Zagouras A, Iakovis N, Papamichalis M, Giamouzis G, Vassilopoulos G, Skoularigis J, Triposkiadis F. Red blood cell distribution width in elderly hospitalized patients with cardiovascular disease. World J Cardiol 2021; 13(9): 503-513 [PMID: 34621495 DOI: 10.4330/wjc.v13.i9.503]
Corresponding Author of This Article
Andrew Xanthopoulos, FACC, MD, PhD, Consultant Physician-Scientist, Department of Cardiology, University Hospital of Larissa, Mezourlo, Larissa 41110, Greece. andrewvxanth@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Prospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Sep 26, 2021; 13(9): 503-513 Published online Sep 26, 2021. doi: 10.4330/wjc.v13.i9.503
Red blood cell distribution width in elderly hospitalized patients with cardiovascular disease
Andrew Xanthopoulos, Konstantinos Tryposkiadis, Apostolos Dimos, Angeliki Bourazana, Alexandros Zagouras, Nikolaos Iakovis, Michail Papamichalis, Grigorios Giamouzis, George Vassilopoulos, John Skoularigis, Filippos Triposkiadis
Andrew Xanthopoulos, Apostolos Dimos, Angeliki Bourazana, Alexandros Zagouras, Nikolaos Iakovis, Michail Papamichalis, Grigorios Giamouzis, John Skoularigis, Filippos Triposkiadis, Department of Cardiology, University Hospital of Larissa, Larissa 41110, Greece
George Vassilopoulos, Department of Haematology, University of Thessaly Medical School, Larissa 41110, Greece
Author contributions: Xanthopoulos A participated in design of the study, drafted the manuscript, participated in the oversight of the study, and was involved in the data collection; Tryposkiadis K drafted the manuscript and performed the statistical analyses; Dimos A participated in design of the study, and was involved in the data collection; Bourazana A participated in the design of the study, and drafted the manuscript; Zagouras A drafted the manuscript and was involved in the data collection; Iakovis N participated in the design of the study and was involved in the data collection; Papamichalis M was involved in the data collection and drafted the manuscript; Giamouzis G participated, Vassilopoulos G, and Skoularigis J participated in the design and oversight of the study; Triposkiadis F participated in the design and oversight of the study and drafted the manuscript; All authors read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the University General Hospital of Larissa, Larissa, Greece Institutional Review Board.
Informed consent statement: The need for written informed consent was waived by the ethics committee due to the observational nature of the study.
Conflict-of-interest statement: The authors declare no conflict of interest regarding the present work
Data sharing statement: No additional data are available
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Andrew Xanthopoulos, FACC, MD, PhD, Consultant Physician-Scientist, Department of Cardiology, University Hospital of Larissa, Mezourlo, Larissa 41110, Greece. andrewvxanth@gmail.com
Received: March 6, 2021 Peer-review started: March 6, 2021 First decision: March 31, 2021 Revised: June 22, 2021 Accepted: August 4, 2021 Article in press: August 4, 2021 Published online: September 26, 2021 Processing time: 195 Days and 19.9 Hours
Abstract
BACKGROUND
Red blood cell distribution width (RDW) is elevated in patients with cardiovascular disease (CVD).
AIM
To determine RDW values and impact of CV and non-CV coexisting morbidities in elderly patients hospitalized with chronic CVD.
METHODS
This prospective study included 204 consecutive elderly patients (age 77.5 [7.41] years, female 94 [46%], left ventricular ejection fraction 53.00% [37.50, 55.00]) hospitalized with chronic CVD at the Cardiology Department of Larissa University General Hospital (Larissa, Greece) from January 2019 to April 2019. Elderly patients were selected due to the high prevalence of coexisting morbidities in this patient population. Hospitalized patients with acute CVD (acute coronary syndromes, new-onset heart failure [HF], and acute pericarditis/myocarditis), primary isolated valvular heart disease, sepsis, and those with a history of blood transfusions or cancer were excluded. The evaluation of the patients within 24 h from admission included clinical examination, laboratory blood tests, and echocardiography.
RESULTS
The most common cardiac morbidities were hypertension and coronary artery disease, with acutely decompensated chronic heart failure (ADCHF) and atrial fibrillation (AF) also frequently being present. The most common non-cardiac morbidities were anemia and chronic kidney disease followed by diabetes mellitus, chronic obstructive pulmonary disease, and sleep apnea. RDW was significantly elevated 15.48 (2.15); 121 (59.3%) of patients had RDW > 14.5% which represents the upper limit of normal in our institution. Factors associated with RDW in stepwise regression analysis were ADCHF (coefficient: 1.406; 95% confidence interval [CI]: 0.830-1.981; P < 0.001), AF (1.192; 0.673 to 1.711; P < 0.001), and anemia (0.806; 0.256 to 1.355; P = 0.004). ADCHF was the most significant factor associated with RDW. RDW was on average 1.41 higher for patients with than without ADCHF, 1.19 higher for patients with than without AF, and 0.81 higher for patients with than without anemia. When patients were grouped based on the presence or absence of anemia, ADCHF and AF, heart rate was not increased in those with anemia but was significantly increased in those with ADCHF or AF.
CONCLUSION
RDW was elevated in elderly hospitalized patients with chronic CVD. Factors associated with RDW were anemia and CV factors associated with elevated heart rate (ADCHF, AF), suggesting sympathetic overactivity.
Core Tip: This was a prospective observational study with 204 consecutive elderly hospitalized patients seeking to evaluate the impact of cardiovascular (CV) and non-CV coexisting morbidities on red blood cell distribution width (RDW). RDW was significantly elevated and factors associated with RDW were anemia as well as CV factors associated with elevated heart rate (acutely decompensated chronic heart failure and atrial fibrillation), suggesting sympathetic overactivity.
