Highlights
- •An association between RDW elevation and thromboembolic risk in AF patients is investigated.
- •Two cut-off points for poor outcome is proposed (generally ≥13.9% and ≥15.5% in heart failure).
- •Patient's clinical risk can be checked again when their RDW level increases during follow-up.
Abstract
Background
We investigated whether an increase in the value of red cell distribution width (RDW)
was associated with thromboembolic outcomes in patients with atrial fibrillation (AF).
Methods
We performed a retrospective analysis of 5082 consecutive patients with non-valvular
AF. Thromboembolic events (N = 723, 14.2%) were recorded and analysed according to RDW value.
Results
The peak RDW value during follow-up was higher in patients with thromboembolic events
than in those without thromboembolic events (15.1% vs. 14.2%, p < 0.001). The RDW value showed similar power in predicting thromboembolic outcomes compared
with the factor of age. The risk of thromboembolic events was higher in patients with
a peak RDW ≥ 13.9% than in patients with a peak RDW < 13.9% (hazard ratio 1.63, p < 0.001), and increased with each quartile increase of RDW. In a subgroup of 739 patients
with congestive heart failure (CHF), there were 112 (15.2%) thromboembolic events.
The peak RDW value of patients with CHF with thromboembolic events was also significantly
higher (16.4% vs. 15.6%, p = 0.019) compared to that of those without thromboembolic events.
Conclusion
An increased RDW value during follow-up could be associated with thromboembolic events
in patients with non-valvular AF. The suggested cut-off values for RDW used to predict
an increased thromboembolic risk in were ≥13.9% in patients with AF in general, ≥15% in patients with co-existing AF and CHF.
Keywords
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Article info
Publication history
Published online: August 04, 2017
Accepted:
July 18,
2017
Received in revised form:
July 6,
2017
Received:
November 23,
2016
Identification
Copyright
© 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
