Red Blood Cell Distribution Width (RDW) in Chronic Heart Failure: Does it have a Prognostic Value in Every Population?

Objectives: Chronic heart failure (CHF) is a global health issue with notable morbidity and mortality. Currently, red cell distribution width (RDW) has appeared to be potential prognostic marker in patients with CHF.This study aims to assess the prognostic value of RDW in Saudi population with CHF. Methods: This study was a retrospective cohort study that included 233 CHF patients treated with standard anti failure drugs. RDW were ascertained at baseline with 2-D echocardiographic assessments of left ventricular mass and function. The follow up period was 24 months. Primary endpoint was the relationship between RDW and all cause mortality (ACM). Secondary endpoints included the potential association with major adverse cardiovascular events (classical 3-point MACE). Results: The mean age of patients was 60.15 +/- 12.24 years, and 64.8% were males. Baseline RDW was 14.40 (13.50, 15.80) % (median, and interquartile ranges); 43 deaths occurred during the follow-up period. RDW was found to be the most significant and independent predictor of ACM, with a hazard ratio (HR) of 1.238 (95% CI; 1.090, 1.407) (P=0.001). While RDW change over 12 months had similar predictive value for ACM with HR 1.226 (95% CI; 1.117, 1.346) (P<0.0001). RDW was also found to be a significant and independent predictor for secondary endpoints. Conclusion: Our study supports the usefulness of RDW as an independent prognostic indicator for ACM and other CV outcomes in Saudi population with CHF.