Comparative analysis of red cell distribution width and high sensitivity C-reactive protein for coronary heart disease mortality prediction in multi-ethnic population: Findings from the 1999–2004 NHANES

Vikas Veeranna; Sandip K Zalawadiya; Sidakpal Panaich; Kushang V Patel; Luis Afonso

doi:10.1016/j.ijcard.2013.07.109

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Comparative analysis of red cell distribution width and high sensitivity C-reactive protein for coronary heart disease mortality prediction in multi-ethnic population: Findings from the 1999–2004 NHANES

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Comparative analysis of red cell distribution width and high sensitivity C-reactive protein for coronary heart disease mortality prediction in multi-ethnic population: Findings from the 1999–2004 NHANES

Vikas Veeranna, Sandip K Zalawadiya, Sidakpal Panaich, Kushang V Patel and Luis Afonso

International journal of cardiology, Vol.168(6), pp.5156-5161

10/15/2013

DOI: 10.1016/j.ijcard.2013.07.109

PMID: 24016543

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Abstract

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 a population cohort free of CVD. Analysis was performed on 8,513 adult participants (age >20years) free of CVD from the National Health and Nutrition Examination Surveys 1999–2004. Cox-proportional hazard analyses were 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. 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, 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, 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 [hs-CRP ≤3mg/L (HR 1.17 95% CI [1.01–1.36] p=0.031)] and hs-CRP >3mg/L (HR 1.44 95% CI [1.23–1.68] p<0.001). Hs-CRP was not predictive in either high or low RDW subgroup. RDW but not hs-CRP was associated with 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 and needs further prospective evaluation in CVD risk assessment.

High sensitivity C-reactive protein

Red cell distribution width

Coronary heart disease mortality

Risk stratification

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Title: Subtitle: Comparative analysis of red cell distribution width and high sensitivity C-reactive protein for coronary heart disease mortality prediction in multi-ethnic population: Findings from the 1999–2004 NHANES
Creators: Vikas Veeranna - Division of Cardiology, Wayne State University, Detroit Medical Center, Detroit, MI, USA
Sandip K Zalawadiya - Division of Cardiology, Wayne State University, Detroit Medical Center, Detroit, MI, USA
Sidakpal Panaich - Division of Cardiology, Wayne State University, Detroit Medical Center, Detroit, MI, USA
Kushang V Patel - Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, USA
Luis Afonso - Division of Cardiology, Wayne State University, Detroit Medical Center, Detroit, MI, USA
Resource Type: Journal article
Publication Details: International journal of cardiology, Vol.168(6), pp.5156-5161
DOI: 10.1016/j.ijcard.2013.07.109
PMID: 24016543
NLM abbreviation: Int J Cardiol
ISSN: 0167-5273
eISSN: 1874-1754
Publisher: Elsevier Ireland Ltd
Language: English
Date published: 10/15/2013
Academic Unit: Cardiovascular Medicine; Internal Medicine
Record Identifier: 9984094677702771

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