RED BLOOD CELL DISTRIBUTION WIDTH PREDICTS MORBIDITY AND MORTALITY AFTER AORTIC VALVE REPLACEMENT

Abstract

Objective: Red blood cell distribution width (RDW), is a measurement of the size variation as well as an erythrocyte heterogeneity index (i.e., anysocytosis). used in combination with the mean corpuscular volume for anemia diagnosis. However, it is emerging as an useful predictor biomarker of mortality and morbidity of cardiovascular diseases. However, until now no literature data there are about the RDW role in predicting mortality after aortic valve replacement (AVR). Thus, in this pilot study biological significance of elevated RDW values in early outcome following AVR was evaluated Methods: We enrolled 75 patients (mean age 73.5 ±7.9 years) subjected to AVR and/ or not co temporally to other surgical procedures . Demographics, comorbidities, clinical presentations, and laboratory parameters were collected. The RDW values were considered elevated when more high than 48 fL. Multivariable and univariable examinations were performed in determine associations between preoperative high RDW values and postoperative outcome. Results: Preoperative higher RDW values had a prevalence of 41% (31 patients) in AVR cases studied. These 31 patients were older (76 ± 5.5 years vs 71.6± 8.9 years, p-value=0,02 ), low weight (69.7 vs. 74.1 Kg, p-value= 0,12) with higher platelet levels (p-value 0,005) than the other 44 cases. In addition, they represented the patients that should have likely required renal replacement therapy (13% vs 0%, p-value = 0.026), and prolonged ventilation (16% vs 0%, p-value =0.01). Multivariable adjustment analysis also demonstrated significant associations between higher preoperative RDW values with high BMI values (p-value= 0.05) and renal failure (p-value= 0,06 and p-value=0,02). Conclusions: Increased RDW values seem to be a good predictor biomarker of early outcome after AVR, particularly in patients with high BMI, renal impairment and postoperative prolonged ventilation