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Published on: August 28, 2018
Association Between Red Blood Cell Distribution Width and Coronary Calcification in Patients Referred for Invasive
Wen Jian1, Xueqian Shen1, Ze Zheng1
1Center for Coronary Artery Disease, Beijing Anzhen Hospital of Capital Medical University, Beijing, China.
Insights
Red cell distribution width standard deviation (RDW-SD) is linked to coronary artery calcification severity. Higher RDW-SD levels indicate a greater likelihood of significant coronary calcification, suggesting its potential as a biomarker.
Area of Science:
- Cardiology
- Biomarkers
- Medical Imaging
Background:
- Coronary artery calcification (CAC) is a marker of atherosclerosis.
- Red cell distribution width (RDW) reflects erythrocyte anisocytosis.
- The association between RDW and CAC requires further investigation.
Purpose of the Study:
- To evaluate the association between red cell distribution width (RDW) and coronary calcification.
- To compare the utility of RDW expressed as standard deviation (RDW-SD) versus coefficient of variation (RDW-CV) in predicting coronary artery calcium score (CACS).
Main Methods:
- Retrospective analysis of 4796 patients who underwent coronary computed tomography angiography and invasive coronary angiography.
- Collection of demographic, clinical, laboratory data, and coronary artery calcium scores (CACS).
- Multivariable ordinal logistic regression analysis to assess the association between RDW (SD and CV) and CACS grades.
Main Results:
- Elevated RDW-SD was significantly associated with higher CACS grades (adjusted OR per 1-SD increase: 1.11; P < .001).
- The 4th quartile of RDW-SD showed a significant association with elevated CACS compared to the 1st quartile (adjusted OR: 1.25; P = .006).
- No significant association was found between RDW-CV and CACS grades.
Conclusions:
- RDW-SD is a robust and independent biomarker for predicting coronary calcification severity.
- RDW-SD may offer clinical utility in assessing atherosclerosis burden compared to RDW-CV.
Abstract:
This study aimed to determine whether red cell distribution width (RDW) is associated with coronary calcification. A total of 4796 patients who underwent coronary computed tomography angiography and subsequent invasive coronary angiography were consecutively enrolled. Coronary artery calcium score (CACS), demographic, clinical, and laboratory data were collected from electronic medical records. RDW were expressed in two forms, as a coefficient of variation (CV) or as a standard deviation (SD). Multivariable ordinal logistic regression was used to investigate the association of RDW with CACS grades (CACS 0-99, 100-399, 400-999, and >1000). A significant association was found between elevated RDW-SD and higher CACS grades after full adjustment (adjusted OR per 1-SD increase: 1.11, 95% CI: 1.05-1.18; P < .001), while no significant association was found between RDW-CV and CACS grades. When RDW-SD was analyzed as a categorical variable, it was primarily the 4th quartile of RDW-SD that was associated with elevated CACS grades compared with the 1st quartile (adjusted OR: 1.25, 95% CI: 1.07-1.46; P = .006), while the 2nd and 3rd quartiles showed no significantly higher risk. RDW-SD is a more robust biomarker for coronary calcification compared with RDW-CV.
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