Universität zu Köln

Emans, Mireille E., Gaillard, Carlo A. J. M., Pfister, Roman, Tanck, Michael W., Boekholdt, S. Matthijs, Wareham, Nick J. and Khaw, Kay-Tee (2013). Red cell distribution width is associated with physical inactivity and heart failure, independent of established risk factors, inflammation or iron metabolism; the EPIC-Norfolk study. Int. J. Cardiol., 168 (4). S. 3550 - 3556. CLARE: ELSEVIER IRELAND LTD. ISSN 1874-1754

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Abstract

Aims: Red cell distribution width (RDW) is associated with increased risk of heart failure (HF). We examined in a healthy population (1) whether this association is independent of cardiovascular risk factors and iron metabolism and (2) whether RDW associates with physical activity. Methods and results: Hazard ratios (HRs, highest quartile versus lowest quartile of RDW) for the risk of HF were calculated in 17,533 participants from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk cohort. During a follow-up of 11.2 +/- 2.2 years 640 participants developed a HF event. The HR for HF events was 1.44 (95%CI 1.15-1.80, p < 0.001). There was a non-linear increase in HF risk across RDW quartiles. Adjustment for established risk factors (sex, age, diabetes, smoking, systolic blood pressure, total and high-density lipoprotein cholesterol) attenuated the HR for HF to 1.40 (95%CI 1.11-1.77, p = 0.001). Adjustment for CRP, iron and ferritin levels did not affect the HR for HF. RDW levels are inversely associated with physical activity (per category beta = -0.37, 95% CI -0.053 to -0.021, p < 0.0001), independent of iron metabolism. However, the association between HF and RDWlevels was not changed by physical activity. Conclusions: This study confirms that RDW is associated with HF events in an apparently healthy middle-aged population. More importantly, we show that the underlying pathophysiology linking HF with anisocytosis is not reflected by conventional risk factors, nor it is explained by iron metabolism or inflammation. Furthermore, RDW levels were associated with physical inactivity, but this did not influence the RDW-associated-risk of heart failure. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Emans, Mireille E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gaillard, Carlo A. J. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Tanck, Michael W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Boekholdt, S. Matthijs UNSPECIFIED UNSPECIFIED UNSPECIFIED Wareham, Nick J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Khaw, Kay-Tee UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-474102
DOI:	10.1016/j.ijcard.2013.05.002
Journal or Publication Title:	Int. J. Cardiol.
Volume:	168
Number:	4
Page Range:	S. 3550 - 3556
Date:	2013
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1874-1754
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EXERCISE CAPACITY; PROGNOSTIC MARKER; LARGE COHORT; MECHANISMS; PREDICTION; BIOMARKERS; DEATH; MORTALITY; ERYPTOSIS; CYTOKINES Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47410