[Correlation between red cell distribution width and the severity and prognosis of chronic thromboembolic pulmonary...

To explore the relationship between circulating red cell distribution width (RDW) and the severity and prognosis of chronic thromboembolic pulmonary hypertension (CTEPH).

A total of 66 consecutive patients with very likely CTEPH diagnosed by echocardiography and/or right heart catheterization were enrolled from August, 2007 to July, 2014. The patients included 31 females and 35 males with a mean age of (58±13) years. Based on the cut-off value of RDW=14%, the patients were divided into 2 groups as RDW>14% group(n=21) and RDW≤14% group(n=45). The baseline profile was recorded and compared between the 2 groups and the follow-up outcomes were analyzed by ROC curves and Logistic regression survival analysis.

The median of follow-up time was 2 years, including 21 dead and 45 survived patients. The RDW level was positively related to creatinine(r=0.258, P=0.037), BNP(r=0.263, P=0.033) and uric acid(r=0.359, P<0.010). ROC analysis showed that RDW, BNP, and uric acid were the effective predictors for all-cause mortality in CTEPH patients(P<0.001, P=0.038, respectively), the area under the curve being 0.734, 0.806, and 0.659 respectively. Based on the cut-off value of 14%, the sensitivity and specificity for RDW prediction for CTEPH mortality was 60% and 80% respectively. The RDW≤14% group had better prognosis than the RDW>14% group (P<0.001). Moreover, the levels of BNP and uric acid were higher in the RDW>14% group than those in the RDW≤14% group(U=-3.558, P<0.05). Multi-Logistic regression analysis showed that RDW>14% was an independent risk factor for predicting death in CTEPH patients.

RDW level was inversely related to the clinical condition and prognosis of CTEPH. Higher RDW, as an independent risk factor for adverse events, was correlated with severity and worse prognosis of the disease.