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Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank.

Publication ,  Journal Article
Felker, GM; Allen, LA; Pocock, SJ; Shaw, LK; McMurray, JJV; Pfeffer, MA; Swedberg, K; Wang, D; Yusuf, S; Michelson, EL; Granger, CB ...
Published in: J Am Coll Cardiol
July 3, 2007

OBJECTIVES: The goal of this study was to identify potentially novel laboratory markers of risk in chronic heart failure patients. BACKGROUND: Although a variety of prognostic markers have been described in heart failure, a systematic assessment of routine laboratory values has not been reported. METHODS: All 2,679 symptomatic chronic heart failure patients from the North American CHARM (Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity) program had a wide range of laboratory measures performed at a core facility, enabling us to assess the relationship between routine blood tests and outcomes using a Cox proportional hazards model. We then replicated our findings in a cohort of 2,140 heart failure patients from the Duke Databank. RESULTS: Among 36 laboratory values considered in the CHARM program, higher red cell distribution width (RDW) showed the greatest association with morbidity and mortality (adjusted hazard ratio 1.17 per 1-SD increase, p < 0.001). Higher RDW was among the most powerful overall predictors, with only age and cardiomegaly showing a better independent association with outcome. This finding was replicated in the Duke Databank, in which higher RDW was strongly associated with all-cause mortality (adjusted hazard ratio 1.29 per 1 SD, p < 0.001), second only to age as a predictor of outcome. CONCLUSIONS: In 2 large contemporary heart failure populations, RDW was found to be a very strong independent predictor of morbidity and mortality. Understanding how and why this marker is associated with outcome may provide novel insights into heart failure pathophysiology.

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Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

July 3, 2007

Volume

50

Issue

1

Start / End Page

40 / 47

Location

United States

Related Subject Headings

  • Tetrazoles
  • Survival Analysis
  • Severity of Illness Index
  • Sensitivity and Specificity
  • Risk Assessment
  • Randomized Controlled Trials as Topic
  • Proportional Hazards Models
  • Prognosis
  • Probability
  • Multivariate Analysis
 

Citation

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Felker, G. M., Allen, L. A., Pocock, S. J., Shaw, L. K., McMurray, J. J. V., Pfeffer, M. A., … CHARM Investigators, . (2007). Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol, 50(1), 40–47. https://doi.org/10.1016/j.jacc.2007.02.067
Felker, G Michael, Larry A. Allen, Stuart J. Pocock, Linda K. Shaw, John J. V. McMurray, Marc A. Pfeffer, Karl Swedberg, et al. “Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank.J Am Coll Cardiol 50, no. 1 (July 3, 2007): 40–47. https://doi.org/10.1016/j.jacc.2007.02.067.
Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJV, Pfeffer MA, et al. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol. 2007 Jul 3;50(1):40–7.
Felker, G. Michael, et al. “Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank.J Am Coll Cardiol, vol. 50, no. 1, July 2007, pp. 40–47. Pubmed, doi:10.1016/j.jacc.2007.02.067.
Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJV, Pfeffer MA, Swedberg K, Wang D, Yusuf S, Michelson EL, Granger CB, CHARM Investigators. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol. 2007 Jul 3;50(1):40–47.
Journal cover image

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

July 3, 2007

Volume

50

Issue

1

Start / End Page

40 / 47

Location

United States

Related Subject Headings

  • Tetrazoles
  • Survival Analysis
  • Severity of Illness Index
  • Sensitivity and Specificity
  • Risk Assessment
  • Randomized Controlled Trials as Topic
  • Proportional Hazards Models
  • Prognosis
  • Probability
  • Multivariate Analysis