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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Association between red cell distribution width and thromboembolic events in patients with atrial fibrillation
Myung-Jin Cha1, Hak Seung Lee1, Hyue Mee Kim1
1Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
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.
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