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Association between Red Cell Distribution Width and Mortality after Cardiac Resynchronization Therapy.

Guy Topaz, Moti Haim, Jairo Kusniec

    The Israel Medical Association Journal : IMAJ
    |September 24, 2015
    PubMed
    Summary

    Elevated red cell distribution width (RDW) before and after cardiac resynchronization therapy (CRT) predicts higher mortality in heart failure patients. This finding highlights RDW as a significant prognostic marker post-CRT implantation.

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    Area of Science:

    • Cardiology
    • Hematology

    Background:

    • Cardiac resynchronization therapy (CRT) is a treatment for heart failure patients with interventricular dyssynchrony.
    • Elevated red cell distribution width (RDW), indicating erythrocyte size heterogeneity, is linked to poor outcomes in chronic heart failure.

    Purpose of the Study:

    • To investigate the association between red cell distribution width (RDW) levels and patient outcomes following CRT implantation.

    Main Methods:

    • A cohort analysis of 156 patients undergoing CRT between 2004-2008 was performed.
    • RDW was measured pre-implantation and at 6 and 12 months post-implantation.
    • All-cause mortality and hospital re-admissions were primary and secondary outcomes, respectively, with a median follow-up of 61 months.

    Main Results:

    • Higher baseline RDW levels were independently associated with all-cause mortality (HR 1.33).
    • RDW levels at 6 and 12 months post-CRT also correlated significantly with mortality.
    • Patients with hospital re-admissions had higher baseline RDW compared to those without.

    Conclusions:

    • Elevated RDW levels before and after CRT implantation are independently associated with increased all-cause mortality.
    • RDW serves as a significant prognostic indicator in patients receiving CRT.