International Journal of Cardiology 190 (2015) 53
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Letter to the Editor
Influence factors might elevate blood red cell distribution width levels in postoperative atrial fibrillation patients Chang-guo Wang, Wei Lei, Jian-an Huang, Da-xiong Zeng ⁎ Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, PR China
a r t i c l e
i n f o
Article history: Received 15 April 2015 Accepted 16 April 2015 Available online 17 April 2015 Keywords: Red cell distribution width Postoperative atrial fibrillation Influence factor
the above abnormalities might help readers to further understand the clinical role of RDW in POAF. Moreover, the device (brand or model) used for RDW detection was not mentioned in this report. It is an essential and important information because RDW levels and reference rage might change greatly with different detection devices or measurement methods [8]. In general, we deemed that the clinical role of RDW in POAF development after elective on-pump cardiac surgery remained debatable. Perhaps, a large-scale prospective study might be beneficial to confirm the clinical value of RDW in POAF development. Conflict of interest None declared.
Dear editor, Funding We have read with great interest the recently published article by Korantzopoulos and colleagues [1]. In this report, authors aimed to examine the potential association of red blood cell distribution width (RDW) with postoperative atrial fibrillation (POAF) and to evaluate its relative value compared to other conventional inflammatory indexes. The results showed that RDW is correlative to POAF development after elective on-pump cardiac surgery. Moreover, RDW was the only parameter which was independently associated with POAF. We admired the authors for this novel issue, but there are some points to be noticed. As a parameter of red blood cell heterogeneity, RDW is widely used as a marker for anemia differential diagnosis. Recently, numerous reports revealed its critical role as a predictor for prognosis and cardiovascular events in multiple diseases, including heart failure, and atrial fibrillation [2–4]. However, plenty of influence factors might affect RDW levels [5,6]. Some disorders have been excluded or adjusted in this study, such as diabetes mellitus, hypertension, thyroid disease and hepatic dysfunction. But, other abnormalities which might also affect RDW levels have not been mentioned or adjusted. For example, transfusion, nutritional status (such as deficiency of iron, vitamin B12 or folic acid), hemolytic anemia, sickle cell anemia, myelodysplatic syndrome, etc. Furthermore, being overweight might also elevated RDW levels [7]. So, body mass index (BMI) might be a better parameter than weight in the subject's baseline demographic characteristics. In brief, details of ⁎ Corresponding author at: Department of Respiratory Medicine, the first affiliated hospital of Soochow University, No. 188, Shizi Street, Suzhou 215006, PR China. E-mail address: [email protected] (D. Zeng).
http://dx.doi.org/10.1016/j.ijcard.2015.04.143 0167-5273/© 2015 Elsevier Ireland Ltd. All rights reserved.
The authors thank the National Nature Science Foundation of China (No. 81100038, 81300026) and Suzhou City's Municipal Youth Fund of Science and Education (No. KJXW2013006). References [1] P. Korantzopoulos, N. Sontis, T. Liu, S. Chlapoutakis, S. Sismanidis, S. Siminelakis, et al., Association between red blood cell distribution width and postoperative atrial fibrillation after cardiac surgery: a pilot observational study, Int. J. Cardiol. 185 (2015) 19–21. [2] V. Veeranna, S.K. Zalawadiya, S. Panaich, K.V. Patel, L. Afonso, Comparative analysis of red cell distribution width and high sensitivity C-reactive protein for coronary heart disease mortality prediction in multi-ethnic population: findings from the 1999–2004 NHANES, Int. J. Cardiol. 168 (2013) 5156–5161. [3] M. Tonelli, F. Sacks, M. Arnold, L. Moye, B. Davis, M. Pfeffer, et al., Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease, Circulation 117 (2008) 163–168. [4] T. Liu, Q. Shao, S. Miao, E. Liu, G. Xu, R. Yuan, G. Li, Red cell distribution width as a novel, inexpensive marker for paroxysmal atrial fibrillation, Int. J. Cardiol. 171 (2014) e52–e53. [5] G.L. Salvagno, F. Sanchis-Gomar, A. Picanza, G. Lippi, Red blood cell distribution width: a simple parameter with multiple clinical applications, Crit. Rev. Clin. Lab. Sci. 1–20 (2014). [6] G. Lippi, M. Plebani, Red blood cell distribution width (RDW) and human pathology. One size fits all, Clin. Chem. Lab. Med. 52 (2014) 1247–1249. [7] B. Fujita, D. Strodthoff, M. Fritzenwanger, A. Pfeil, M. Ferrari, B. Goebel, et al., Altered red blood cell distribution width in overweight adolescents and its association with markers of inflammation, Pediatr. Obes. 8 (2013) 385–391. [8] G. Lippi, F. Pavesi, M. Bardi, S. Pipitone, Lack of harmonization of red blood cell distribution width (RDW). Evaluation of four hematological analyzers, Clin. Biochem. 47 (2014) 1100–1103.
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Letter to the Editor
Influence factors might elevate blood red cell distribution width levels in postoperative atrial fibrillation patients Chang-guo Wang, Wei Lei, Jian-an Huang, Da-xiong Zeng ⁎ Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, PR China
a r t i c l e
i n f o
Article history: Received 15 April 2015 Accepted 16 April 2015 Available online 17 April 2015 Keywords: Red cell distribution width Postoperative atrial fibrillation Influence factor
the above abnormalities might help readers to further understand the clinical role of RDW in POAF. Moreover, the device (brand or model) used for RDW detection was not mentioned in this report. It is an essential and important information because RDW levels and reference rage might change greatly with different detection devices or measurement methods [8]. In general, we deemed that the clinical role of RDW in POAF development after elective on-pump cardiac surgery remained debatable. Perhaps, a large-scale prospective study might be beneficial to confirm the clinical value of RDW in POAF development. Conflict of interest None declared.
Dear editor, Funding We have read with great interest the recently published article by Korantzopoulos and colleagues [1]. In this report, authors aimed to examine the potential association of red blood cell distribution width (RDW) with postoperative atrial fibrillation (POAF) and to evaluate its relative value compared to other conventional inflammatory indexes. The results showed that RDW is correlative to POAF development after elective on-pump cardiac surgery. Moreover, RDW was the only parameter which was independently associated with POAF. We admired the authors for this novel issue, but there are some points to be noticed. As a parameter of red blood cell heterogeneity, RDW is widely used as a marker for anemia differential diagnosis. Recently, numerous reports revealed its critical role as a predictor for prognosis and cardiovascular events in multiple diseases, including heart failure, and atrial fibrillation [2–4]. However, plenty of influence factors might affect RDW levels [5,6]. Some disorders have been excluded or adjusted in this study, such as diabetes mellitus, hypertension, thyroid disease and hepatic dysfunction. But, other abnormalities which might also affect RDW levels have not been mentioned or adjusted. For example, transfusion, nutritional status (such as deficiency of iron, vitamin B12 or folic acid), hemolytic anemia, sickle cell anemia, myelodysplatic syndrome, etc. Furthermore, being overweight might also elevated RDW levels [7]. So, body mass index (BMI) might be a better parameter than weight in the subject's baseline demographic characteristics. In brief, details of ⁎ Corresponding author at: Department of Respiratory Medicine, the first affiliated hospital of Soochow University, No. 188, Shizi Street, Suzhou 215006, PR China. E-mail address: [email protected] (D. Zeng).
http://dx.doi.org/10.1016/j.ijcard.2015.04.143 0167-5273/© 2015 Elsevier Ireland Ltd. All rights reserved.
The authors thank the National Nature Science Foundation of China (No. 81100038, 81300026) and Suzhou City's Municipal Youth Fund of Science and Education (No. KJXW2013006). References [1] P. Korantzopoulos, N. Sontis, T. Liu, S. Chlapoutakis, S. Sismanidis, S. Siminelakis, et al., Association between red blood cell distribution width and postoperative atrial fibrillation after cardiac surgery: a pilot observational study, Int. J. Cardiol. 185 (2015) 19–21. [2] V. Veeranna, S.K. Zalawadiya, S. Panaich, K.V. Patel, L. Afonso, Comparative analysis of red cell distribution width and high sensitivity C-reactive protein for coronary heart disease mortality prediction in multi-ethnic population: findings from the 1999–2004 NHANES, Int. J. Cardiol. 168 (2013) 5156–5161. [3] M. Tonelli, F. Sacks, M. Arnold, L. Moye, B. Davis, M. Pfeffer, et al., Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease, Circulation 117 (2008) 163–168. [4] T. Liu, Q. Shao, S. Miao, E. Liu, G. Xu, R. Yuan, G. Li, Red cell distribution width as a novel, inexpensive marker for paroxysmal atrial fibrillation, Int. J. Cardiol. 171 (2014) e52–e53. [5] G.L. Salvagno, F. Sanchis-Gomar, A. Picanza, G. Lippi, Red blood cell distribution width: a simple parameter with multiple clinical applications, Crit. Rev. Clin. Lab. Sci. 1–20 (2014). [6] G. Lippi, M. Plebani, Red blood cell distribution width (RDW) and human pathology. One size fits all, Clin. Chem. Lab. Med. 52 (2014) 1247–1249. [7] B. Fujita, D. Strodthoff, M. Fritzenwanger, A. Pfeil, M. Ferrari, B. Goebel, et al., Altered red blood cell distribution width in overweight adolescents and its association with markers of inflammation, Pediatr. Obes. 8 (2013) 385–391. [8] G. Lippi, F. Pavesi, M. Bardi, S. Pipitone, Lack of harmonization of red blood cell distribution width (RDW). Evaluation of four hematological analyzers, Clin. Biochem. 47 (2014) 1100–1103.
