红细胞分布宽度与老年心力衰竭合并心房颤动患者预后关系的研究

Association between red blood cell distribution width and poor outcome in HF patients with AF

目的探讨红细胞分布宽度(RDW)与老年心力衰竭合并心房颤动患者不良预后的关系。方法选取2017年6月~2019年12月郑州大学第一附属医院心内科住院的老年心力衰竭合并心房颤动患者831例,根据RDW最佳截断值分为低RDW组596例(RDW<14.39%),高RDW组235例(RDW≥14.39%)。平均电话随访(2.25±0.64)个月,观察并记录主要终点事件发生情况,包括全因死亡、心源性死亡和因心力衰竭再入院。结果随访期间,2组因心力衰竭再入院比例比较,无统计学差异(P>0.05);高RDW组全因死亡、心源性死亡比例明显高于低RDW组(27.2%vs 8.1%,19.1%vs 5.2%,P<0.01)。多因素Cox回归分析显示,RDW水平与全因死亡、心源性死亡发生风险呈正相关(HR=1.634,95%CI:1.267~1.979,P<0.01;HR=1.323,95%CI:1.173~1.672,P<0.01)。结论升高的RDW与老年心力衰竭合并心房颤动患者不良预后密切相关,是其独立预测因素。

Objective To study the association between red blood cell distribution width(RDW)and poor outcome in elderly HF patients with AF.Methods Eight hundred and thirty-one elderly HF patients with AF admitted to our hospital from June 2017 to December 2019 were divided into RDW<14.39%group(n=596)and RDW≥14.39%group(n=235)according to its optimal cutoff value.The patients were followed up for 2.25±0.64 years by telephone,during which the primary end point events were recorded,including all-cause death,cardiogenic death,and rehospitalization due to HF.Results No significant difference was detected in the rate of rehospitalization due to HF between the two groups during the follow-up period(P>0.05).The incidence of allcause death and cardiogenic death was significantly higher in RDW≥14.39%group than in RDW<14.39%group(27.2%vs 8.1%,19.1%vs 5.2%,P<0.01).Multivariate Cox regression analysis showed that the RDW was positively associated with the risk of all-cause death and cardiogenic death(HR=1.634,95%CI:1.267-1.979,P<0.01;HR=1.323,95%CI:1.173-1.672,P<0.01).Conclusion Elevated RDW is closely associated with and an independent predictor for the poor outcome in elderly HF patients with AF.