Background: Red blood cell distribution width (RDW) is a predictor of adverse outcomes in patients with heart disease.
Aim: To establish predictors of high RDW values in patients with congenital heart disease (CHD), and their relationship with cardiovascular events.
Methods: Overall, 561 patients with stable CHD who attended a single outpatient clinic and a matched control population of 2128 patients were studied. Exclusion criteria were renal failure, anaemia, receiving iron therapy and cyanosis. Blood tests included glucose, creatinine, iron, apoferritin, liver enzymes and a complete blood count. C-reactive protein and N-terminal prohormone of B-type natriuretic peptide (NT-pro-BNP) concentrations were also measured in patients with CHD. Major adverse cardiac events (MACE) were defined as cardiovascular/total mortality, arterial thrombotic events, arrhythmias, major bleedings, pulmonary embolism or heart failure needing hospital admission.
Results: The median age in patients with CHD was 23 (17-36) years and the median follow-up time was 5.8 (3.2-8.7) years; 103 (4.8%) controls and 40 (7.1%) patients with CHD had an RDW>15% (P=0.032). During follow-up, MACE were reported in 48 patients. CHD of great complexity, cardiovascular risk factors, low haemoglobin concentration and high NT-pro-BNP concentration were risk factors for an RDW>15%. Kaplan-Meier analysis showed a significantly worse cardiovascular outcome in patients with CHD with an RDW>15% (P<0.001). The multivariable survival analysis determined that age, CHD of great complexity, high NT-pro-BNP concentration and an RDW>15% were independent predictive factors for MACE.
Conclusion: RDW and NT-pro-BNP concentration are independent analytical predictors of MACE in patients with CHD.
Keywords: Cardiopathie congénitale; Congenital heart disease; Haemoglobin; Hémoglobine; NT-pro-BNP; NT-proBNP; Red blood cell distribution width; Survie; Survival; Variation de la grosseur des hématies.
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