RELATIONSHIP BETWEEN RED CELL DISTRIBUTION WIDTH AND SUBCLINICAL MYOCARDIAL INJURY IN THE GENERAL POPULATION

Therapeutic Area

ASCVD/CVD Risk Factors

Background

Red cell distribution width (RDW) is a marker of anisocytosis, defined as heterogeneity in red blood cell (RBC) size. Elevated RDW has been associated with cardiovascular disease (CVD) and mortality, but the relationship with subclinical CVD is not well established.

Methods

We examined the cross-sectional associations between RDW and subclinical myocardial injury (SCMI), as a measure of subclinical CVD, using the National Health and Nutrition Examination Survey (NHANES-III). We considered participants who had complete electrocardiogram and RDW data available. Participants who were without CVD or anemia (hemoglobin <14 males and <12 for females) at the time of enrollment were included. RDW was measured using the Coulter automated hematology analyzer, which counts and sizes RBCs using a fluid suspension technique. NHANES-III reports RDW as a coefficient of variation. We defined RDW ≤ 14.5 as normal and RDW >14.5 as high. SCMI was defined as a cardiac infarction injury score (CIIS) ≥10 using ECG metrics. Multivariate logistic regression was used to investigate the correlation between RDW (high vs. normal and across tertiles) and SCMI.

Results

This analysis included 5,716 participants (age 58.8±13.0 years, female 56.7%, White 52.2%). The adjusted odds ratio (OR [95% CI]) of SCMI associated with each one unit increase in RDW was 1.16(1.08-1.24; p<0.001). Participants with RDW>14.5 had 39% greater odds of SCMI than participants with RDW ≤14.5 (p=0.007). Participants in tertile 2 and tertile 3 had a 19% and 43% greater odds of SCMI, respectively, compared to participants in tertile 1 (Table).

Conclusions

Our analysis found that increased RDW is associated with SCMI. Further research is warranted to elucidate the mechanism by which high RDW contributes to subclinical CVD.