Laura A Petrauskas1, Lesley Ann Saketkoo2, Thomas Kazecki1, Shigeki Saito2, Vijay Jaligam3, Bennett P deBoisblanc4, Matthew R Lammi5. 1. Louisiana State University Health Sciences Center, School of Medicine, New Orleans, LA, USA. 2. Comprehensive Pulmonary Hypertension Center-University Medical Center, New Orleans, LA, USA; Tulane University School of Medicine, New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, LA, USA. 3. Louisiana State University Health Sciences Center, Section of Cardiology, Medical Director of Cardiology-JenCare NOLA, New Orleans, LA, USA. 4. Comprehensive Pulmonary Hypertension Center-University Medical Center, New Orleans, LA, USA; Louisiana State University Health Sciences Center, Section of Pulmonary/Critical Care and Allergy/Immunology, New Orleans, LA, USA. 5. Comprehensive Pulmonary Hypertension Center-University Medical Center, New Orleans, LA, USA; Louisiana State University Health Sciences Center, Section of Pulmonary/Critical Care and Allergy/Immunology, New Orleans, LA, USA. Electronic address: mlammi@lsuhsc.edu.
Abstract
BACKGROUND: Pulmonary hypertension (PH) often presents with non-specific symptoms making early diagnosis difficult. Red cell distribution width (RDW) is a parameter routinely reported on an automated complete blood cell count that has been associated with numerous disease states. The purpose of this study was to further evaluate RDW as a biomarker for PH in at-risk populations. METHODS: In a retrospective, cross-sectional analysis of patients seen at a PH center over 1 year, we examined both patients with PH and patients at risk for but without PH (e.g. systemic sclerosis, [SSc]). We also studied a group of age-and sex-matched, non-diseased controls. Relevant characteristics were compared among the 3 groups using one-way ANOVA. Similar comparisons were made across World Health Organization (WHO) PH groups 1-4. RESULTS: RDW was highest in the PH patients (n = 181), intermediate in the at-risk for PH patients (n = 52), and lowest in matched controls (n = 100) (15.9 ± 2.8 vs 14.8 ± 2.8 vs 14.2 ± 1.1%, respectively; p < 0.0001). There were no significant differences in RDW across WHO PH groups (p = 0.50). SSc patients with PH had significantly higher RDW values compared to SSc patients without PH (16.0 ± 2.2 vs 14.4 ± 1.9%, respectively; p = 0.03). CONCLUSIONS: RDW is significantly higher in PH patients, without regard to disease etiology, when compared to age- and sex-matched non-diseased controls. Importantly, RDW is also higher in PH patients compared to at-risk patients, particularly in the SSc cohort. The ease of obtaining RDW as a biomarker may help detect incident PH at earlier stages among patients who are at high risk for development of PH.
BACKGROUND:Pulmonary hypertension (PH) often presents with non-specific symptoms making early diagnosis difficult. Red cell distribution width (RDW) is a parameter routinely reported on an automated complete blood cell count that has been associated with numerous disease states. The purpose of this study was to further evaluate RDW as a biomarker for PH in at-risk populations. METHODS: In a retrospective, cross-sectional analysis of patients seen at a PH center over 1 year, we examined both patients with PH and patients at risk for but without PH (e.g. systemic sclerosis, [SSc]). We also studied a group of age-and sex-matched, non-diseased controls. Relevant characteristics were compared among the 3 groups using one-way ANOVA. Similar comparisons were made across World Health Organization (WHO) PH groups 1-4. RESULTS: RDW was highest in the PH patients (n = 181), intermediate in the at-risk for PH patients (n = 52), and lowest in matched controls (n = 100) (15.9 ± 2.8 vs 14.8 ± 2.8 vs 14.2 ± 1.1%, respectively; p < 0.0001). There were no significant differences in RDW across WHO PH groups (p = 0.50). SSc patients with PH had significantly higher RDW values compared to SSc patients without PH (16.0 ± 2.2 vs 14.4 ± 1.9%, respectively; p = 0.03). CONCLUSIONS: RDW is significantly higher in PH patients, without regard to disease etiology, when compared to age- and sex-matched non-diseased controls. Importantly, RDW is also higher in PH patients compared to at-risk patients, particularly in the SSc cohort. The ease of obtaining RDW as a biomarker may help detect incident PH at earlier stages among patients who are at high risk for development of PH.
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