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Red cell distribution width and carotid atherosclerosis progression. The Tromsø Study
Jostein Lappegård1, Trygve S Ellingsen, Anders Vik
1Jostein Lappegård, K. G.Jebsen Thrombosis Research and Expertise Centre, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway, Tel.: +47 90568257,
Insights
Red cell distribution width (RDW) indicates erythrocyte size variability and is linked to cardiovascular disease. Higher RDW levels correlated with increased atherosclerotic plaque progression in a general population study.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Vascular Biology
Background:
- Red cell distribution width (RDW) is a known predictor of cardiovascular morbidity and mortality.
- The association between RDW and the progression of atherosclerosis requires further investigation.
Purpose of the Study:
- To examine the relationship between RDW and the progression of atherosclerotic plaques in a general population cohort.
- To determine if RDW predicts changes in carotid plaque area over time.
Main Methods:
- Utilized data from 4677 participants in the Tromsø Study (1994/95).
- Assessed carotid plaque prevalence and total plaque area (TPA) via ultrasonography at baseline and after 7 years.
- Employed generalized linear models to analyze TPA changes across RDW tertiles, adjusting for cardiovascular risk factors.
Main Results:
- A significant positive association was observed between RDW tertiles and TPA progression.
- Mean TPA change increased from 5.6 mm² in the lowest RDW tertile to 6.7 mm² in the highest tertile (multivariable analysis).
- A 1% increase in RDW was associated with a 0.6 mm² increase in TPA (p=0.03).
Conclusions:
- RDW is independently associated with the progression of atherosclerosis, even after adjusting for traditional risk factors.
- The findings suggest that atherosclerosis may mediate the link between RDW and cardiovascular outcomes.
- RDW may serve as a valuable biomarker for monitoring atherosclerotic disease progression.
Abstract:
Red cell distribution width (RDW), a measure of the size variability of circulating erythrocytes, is associated with cardiovascular morbidity and mortality. We aimed to investigate whether RDW was associated with progression of atherosclerotic plaques in subjects recruited from the general population. Baseline characteristics, including RDW, were collected from 4677 participants in the fourth survey of the Tromsø Study conducted in 1994/95. Prevalence of carotid plaques and total plaque area (TPA) were assessed by ultrasonographic imaging at baseline and after seven years of follow-up. Generalised linear models were used to analyse change in TPA across tertiles of RDW. Change in TPA was significantly higher across tertiles of RDW in crude analysis and in multivariable analysis adjusted for cardiovascular risk factors. The mean change in TPA increased from 5.6 mm² (4.9-6.4) in tertile 1 (RDW ≤ 12.6 %) to 6.7 mm² (5.9-7.6) in tertile 3 (RDW ≥ 13.3) in multivariable analysis adjusted for body mass index, total cholesterol, HDL cholesterol, systolic blood pressure, self-reported diabetes, smoking status, platelet count, white blood cell count, and hs-CRP levels (p for trend 0.003). A 1 % increase in RDW was associated with 0.6 mm² (0.1-1.2) increase in TPA in multivariable analysis (p=0.03). RDW was associated with progression of atherosclerosis after adjustments for traditional atherosclerotic risk factors. Our findings suggest that the link between RDW and cardiovascular morbidity and mortality may be explained by atherosclerosis.