AUTHOR=Campodonico Jeness , Carulli Ermes , Doni Francesco , Russo Gerardo Lo , Junod Daniele , Gaudenzi Asinelli Margherita , Bonomi Alice , De Martino Fabiana , Vignati Carlo , Pezzuto Beatrice , Agostoni Piergiuseppe
TITLE=Is red distribution width a valid tool to predict impaired iron transport in heart failure?
JOURNAL=Frontiers in Cardiovascular Medicine
VOLUME=10
YEAR=2023
URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1133233
DOI=10.3389/fcvm.2023.1133233
ISSN=2297-055X
ABSTRACT=BackgroundImpaired iron transport (IIT) is a form of iron deficiency (ID) defined as transferrin saturation (TSAT) < 20% irrespective of serum ferritin levels. It is frequently observed in heart failure (HF) where it negatively affects prognosis irrespective of anaemia.
ObjectivesIn this retrospective study we searched for a surrogate biomarker of IIT.
MethodsWe tested the predictive power of red distribution width (RDW), mean corpuscular volume (MCV) and mean corpuscular haemoglobin concentration (MCHC) to detect IIT in 797 non-anaemic HF patients.
ResultsAt ROC analysis, RDW provided the best AUC (0.6928). An RDW cut-off value of 14.2% identified patients with IIT, with positive and negative predictive values of 48 and 80%, respectively. Comparison between the true and false negative groups showed that estimated glomerular filtration rate (eGFR) was significantly higher (p = 0.0092) in the true negative vs. false negative group. Therefore, we divided the study population according to eGFR value: 109 patients with eGFR ≥ 90 ml/min/1.73 m2, 318 patients with eGFR 60–89 ml/min/1.73 m2, 308 patients with eGFR 30–59 ml/min/1.73 m2 and 62 patients with eGFR < 30 ml/min/1.73 m2. In the first group, positive and negative predictive values were 48 and 81% respectively, 51 and 85% in the second group, 48 and 73% in the third group and 43 and 67% in the fourth group.
ConclusionRDW may be seen as a reliable marker to exclude IIT in non-anaemic HF patients with eGFR ≥60 ml/min/1.73 m2.