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Red cell distribution width in relation to incidence of coronary events and case fatality rates: a population-based cohort study
  1. Yan Borné1,
  2. J Gustav Smith1,2,3,
  3. Olle Melander1,
  4. Gunnar Engström1
  1. 1Department of Clinical Sciences, Lund University, Skåne University hospital, Malmö, Sweden
  2. 2Department of Cardiology, Lund University, Skåne University Hospital, Lund, Sweden
  3. 3Program of Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
  1. Correspondence to Dr Yan Borné, Department of Clinical Sciences in Malmö, Lund University, Clinical Research Centre (CRC), Entrance 72, house 60, level 13, Skåne University Hospital, Malmö SE 205 02, Sweden; Yan.Borne{at}med.lu.se

Abstract

Aims High red cell distribution width (RDW) is a strong prognostic factor in patients with cardiovascular disease. We investigated the association between RDW and incidence of acute coronary events (CEs) and fatal outcome in subjects who subsequently experienced a first CE.

Methods and results RDW was measured in 26 820 subjects (aged 45–73 years, 61.6% women), without history of myocardial infarction or stroke, who participated in the Malmö Diet and Cancer study during 1991–1996. Cox proportional hazards model was used to analyse the association between RDW and CE. During a mean follow-up of 14 years, 1995 subjects had a first CE, of which 415 subjects died on the same day as the CE (fatal on day 1), another 86 died within 28 days (fatal in 28 days) and 1494 were non-fatal (survived >28 days). After adjustment for risk factors, baseline RDW was significantly associated with incidence of fatal CE (HR 1.82, CI 1.35 to 2.44) but not with non-fatal CE (HR 0.96, CI 0.82 to 1.12). Among all subjects with a CE during follow-up, the proportion who died on day 1 was 13.7%, 18.2%, 22.5% and 26.7%, respectively, for first, second, third and fourth quartiles of RDW.

Conclusions In this population-based study of subjects without history of CE or stroke, high RDW was associated with increased incidence of fatal CE. No relationship was observed for incidence of non-fatal CE.

  • CORONARY ARTERY DISEASE

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