Red blood cell distribution width (RDW), a routinely available and inexpensive hematologic parameter, has been associated with adverse cardiovascular outcomes and may provide additional value for heart failure (HF) risk assessment. A prospective population-based cohort study published in the International Journal of Cardiology evaluated the relationship between RDW and incident HF and examined whether RDW improves HF risk prediction alongside NT-proBNP.
RDW measurements were available for 5,814 individuals without prior HF, while NT-proBNP data were available for 3,393 participants. Over a median follow-up of 7 years, 433 individuals developed HF, corresponding to an incidence rate of 10.4 per 1000 person-years. Associations with incident HF were assessed using fully adjusted Cox proportional hazards models incorporating traditional cardiovascular risk factors.
Findings
- Each 1% increase in RDW was associated with a 22% higher risk of incident HF (HR 1.22; 95% CI, 1.12-1.32).
- Individuals in the highest RDW quartile had a 71% higher HF risk versus the reference group (HR 1.71; 95% CI, 1.29-2.25).
- NT-proBNP was also associated with incident HF risk (HR 1.68; 95% CI, 1.40-2.01 per 1-unit increase).
- Adding RDW to the Pooled Cohort Equations improved predictive discrimination (Δc-statistic = 0.008).
NT-proBNP improved predictive discrimination with a Δc-statistic increase of 0.014.
In this prospective population-based cohort, higher RDW levels were independently associated with increased risk of incident HF during long-term follow-up.
