Red blood cell distribution width, relative lymphocyte count, and type 2 diabetes predict all‑cause mortality in patients with advanced heart failure

Pol Arch Intern Med. 2018 Feb 28;128(2):115-120. doi: 10.20452/pamw.4149. Epub 2017 Nov 9.


INTRODUCTION Early identification of patients with advanced heart failure (HF) who are at higher risk of poor outcome is an important element of patient management, both from the medical and economic standpoint. OBJECTIVES We sought to determine the association between hematologic parameters assessed on admission and within a 3‑year follow‑up in consecutive patients with advanced HF. We also investigated the association between baseline demographic and clinical data and mortality. PATIENTS AND METHODS We analyzed the data of consecutive patients with advanced HF from the single‑center registry COMMIT‑HF. Patients with hematologic and autoimmune disorders, acute or chronic inflammatory diseases, malignant diseases, incomplete clinical and laboratory data, and those receiving glucocorticoids were excluded from the study. RESULTS We analyzed 785 patients with advanced HF out of the total number of 1798 patients included in the COMMIT‑HF registry between 2009 and 2013. The mean (SD) age of the patients was 61.9 (12.4) years, and 76.8% of them were male. Diabetes (hazard ratio [HR], 1.46; 95% CI, 1.15-1.86; P = 0.002), elevated red blood cell distribution width (RDW; HR, 1.05; 95% CI, 1.04-1.07; P <0.0001), and a low relative lymphocyte count (RLC%; HR, 0.942; 95% CI, 0.928-0.956; P <0.0001) were shown to be independent predictors of death. CONCLUSIONS Our study showed that diabetes is a strong independent predictor of death in patients with advanced HF. RDW and RLC% are simple, accurate, and widely available markers predicting mortality at 3 years in patients with advanced HF.

MeSH terms

  • Aged
  • Diabetes Mellitus, Type 2*
  • Erythrocyte Indices*
  • Female
  • Heart Failure / epidemiology*
  • Humans
  • Lymphocyte Count*
  • Male
  • Middle Aged
  • Poland / epidemiology
  • Registries*
  • Risk Assessment