Clinical InvestigationCongestive Heart FailureRed cell distribution width in heart failure: Prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state
Section snippets
Patient population
The study was carried out in accordance with the Helsinki Declaration at the 3rd Department of Internal Medicine, Semmelweis University, based on a study protocol approved by the highest Ethical Committee of Hungary. Consecutive patients with clinical suspicion of congestive heart failure (CHF) referred to transthoracic echocardiography were considered for inclusion. All patients with <45% left ventricular ejection fraction who provided written informed consent were included independently of
Population characteristics
Baseline characteristics of the patient population are presented in Table I. All of the patients had left ventricular systolic dysfunction (left ventricular ejection fraction <45%), while New York Heart Association (NYHA) class ranged from I to IV. Nineteen clinical chemistry, biochemical, or hematology variables were considered as potential covariates or predictors of outcome (listed in Table II). To rule out bias by duration of follow-up and to better reflect the association of the predictors
Discussion
This is the first observational prospective study independently validating the original observations of Felker et al9 on the prognostic value of red cell distribution width in patients with chronic heart failure. This finding was observed in a prospective cohort of unselected patients with chronic heart failure characterized by left ventricular systolic dysfunction. Primary outcomes in this study were rehospitalization due to worsening of HF symptoms and/or all-cause mortality. In the final
Acknowledgements
We thank our patients who agreed to participate in this study. We thank Donald Silverberg for critical reading of the manuscript. The skillful technical assistance of Holeczky Rudolfné, Szigeti Antalné, Korponai Gézáné, Piroska Sturmann, and Márta Kókai is acknowledged with many thanks.
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