Abstract 12295: Comparative Analysis of Red Cell Distribution Width and High Sensitivity C - Reactive Protein for Coronary Heart Disease Mortality Prediction in Multi-Ethnic Population Free of Cardiovascular Disease
Background: Red cell distribution width (RDW) has been shown to predict all cause and cardiovascular (CVD) mortality. However, the predictive ability of RDW for future coronary heart disease (CHD) mortality in comparison to high sensitivity C-reactive protein (hs-CRP) has not been assessed in individuals without pre-existing CVD.
Methods: Analysis was performed on 8513 adult participants (age >20years) free of CVD from the National Health and Nutrition Examination Surveys 1999-2004. Cox-proportional hazard analyses, was used to assess the role of RDW and hs-CRP in CHD mortality and in subgroups based on high and low RDW and hs-CRP.
Results: On adjustment for traditional risk factors (age, sex, systolic blood pressure, anti-hypertensive medication use, total cholesterol , high density lipoprotein cholesterol, lipid lowering therapy, smoking and diabetes mellitus), anemia, mean corpuscular volume and nutritional deficiencies, RDW (hazard ratio (HR) 1.26 95% Confidence Interval (CI)[1.12 - 1.42] p <0.001] remained an independent predictor of CHD mortality , while hs- CRP [HR 1.18 95% CI [0.98 - 1.41] p= 0.077] did not. On comparative analysis, high RDW (>12.6%) was predictive of CHD mortality irrespective of hs-CRP status [CRP ≤3 mg/L (HR 1.17 95%CI [1.01-1.36] p = 0.031) and CRP >3 mg/L (HR 1.44 95% CI [1.23-1.68] p <0.001]. Hs-CRP was not predictive in either high or low RDW subgroups. (Table 1) Figure 1 shows the Nelson-Aalen cumulative hazard estimates for RDW and hs-CRP.
Conclusion: RDW but not hs-CRP was predictive of CHD mortality independent of traditional risk factors in a cohort with no pre-existing CVD. RDW may be considered a stronger biomarker for CHD death than hs-CRP.
- © 2011 by American Heart Association, Inc.