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Predictive ability of red blood cell distribution width for negative remodeling of type B aortic dissection
Qingsong Wu1, Xinfan Lin1, Xingfeng Chen1
1Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, P.R. China; Department of Cardiovascular Surgery, Fujian Medical University, Fuzhou, P.R. China.
Objective:
To investigate the correlation between red blood cell distribution width (RDW) and negative remodeling (NR) in type B aortic dissection (TBAD).
Methods:
This study involved the retrospective analysis of clinical data of 264 patients with nonsurgical TBAD admitted to our hospital between September 2015 and September 2022. Patients underwent regular follow-up after discharge, including periodic chest and abdominal aortic computed tomography angiography. Aortic dissection false lumen expansion was evaluated based on computed tomography angiography images taken at the final follow-up. Patients were divided into two groups based on the occurrence of NR in aortic dissection: NR and non-NR groups.
Results:
A total of 264 patients with an average age of 60 years (63.6% male), with a mean follow-up duration of 53.5 months and a survival rate of 87.9% (232/264 patients), were enrolled. During the follow-up period, 87 patients (33.0%) developed NR of the aortic dissection (NR group). Twenty-four patients in the NR group underwent surgery, which was significantly higher than the number of patients in the non-NR group (27.6% vs 16.9%). One patient in each group died of aortic rupture. RDW levels were significantly higher in the NR than the non-NR group (13.7 ± 1.2 vs 12.7 ± 1.0; P < .001). Spearman's correlation analysis identified a positive correlation between RDW and NR (r = 0.368; P < .001). Multivariate logistic regression analysis identified elevated RDW (odds ratio, 3.910; P < .001) as an independent risk factor for NR. The receiver operating characteristic curve indicated that a cutoff point of RDW >13.7% achieved an area under the curve for prediction of 0.770, sensitivity of 75.1%, and specificity of 93.2% (95% confidence interval, 0.722-0.818; P < .001).
Conclusions:
RDW is a simple, inexpensive, and effective predictive marker of NR in TBAD. Herein, we identified that an RDW of >13.7% is a risk factor for NR in patients with nonsurgical TBAD during follow-up. This limit may provide a reliable basis for assessing the need for surgical intervention, optimizing prognosis evaluation, and making clinical decisions, ultimately improving the long-term survival and quality of life of patients.
