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Red cell distribution width and risk of peripheral artery disease: analysis of National Health and Nutrition Examination Survey 1999-2004.
Vasc Med. 2012 Jun; 17(3):155-63.VM

Abstract

Red cell distribution width (RDW) is an independent predictor of the 10-year estimated risk of coronary heart disease (CHD) events. However, RDW's association with peripheral artery disease (PAD) - a CHD risk equivalent - has not been evaluated to date. In this cross-sectional study, we examined 6950 participants of the National Health and Nutrition Examination Survey, 1999-2004. PAD was defined as an ankle-brachial index below 0.9 (n = 618). RDW was divided into quartiles (Q) (Q1: ≤ 12.2; Q2: 12.3-12.5; Q3: 12.6-13.0; Q4: ≥ 13.1) and PAD risk was compared across these quartiles using adjusted multivariate logistic regression. A graded increase in prevalent PAD with increasing RDW quartiles was observed (4.2% in Q1 vs 13.9% in Q4; test of trend p < 0.001). Risk of PAD was significantly higher (odds ratio (OR) 1.19, 95% confidence interval (CI): 1.06-1.34; p = 0.003) after adjusting for age, sex, race, body mass index, hypertension, hyperlipidemia, diabetes, smoking, estimated glomerular filtration rate, C-reactive protein, hemoglobin, mean corpuscular volume, and nutritional factors (folate, iron and vitamin B(12)) deficiencies with each unit (0.1) increase in RDW. Upon receiver-operating characteristics analysis, the predictive accuracy of the American College of Cardiology / American Heart Association (ACC/AHA)-defined PAD screening criteria (for a high-risk population) was 0.657 at best, but improved significantly (0.727) after addition of RDW (p < 0.0001). In conclusion, higher levels of RDW are independently associated with a higher risk of PAD and can significantly improve the risk prediction beyond that estimated by ACC/AHA-defined PAD screening criteria.

Authors+Show Affiliations

Division of Cardiology, Department of Internal Medicine, Detroit Medical Center/Wayne State University, Detroit, MI 48201, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22615191

Citation

Zalawadiya, Sandip K., et al. "Red Cell Distribution Width and Risk of Peripheral Artery Disease: Analysis of National Health and Nutrition Examination Survey 1999-2004." Vascular Medicine (London, England), vol. 17, no. 3, 2012, pp. 155-63.
Zalawadiya SK, Veeranna V, Panaich SS, et al. Red cell distribution width and risk of peripheral artery disease: analysis of National Health and Nutrition Examination Survey 1999-2004. Vasc Med. 2012;17(3):155-63.
Zalawadiya, S. K., Veeranna, V., Panaich, S. S., & Afonso, L. (2012). Red cell distribution width and risk of peripheral artery disease: analysis of National Health and Nutrition Examination Survey 1999-2004. Vascular Medicine (London, England), 17(3), 155-63. https://doi.org/10.1177/1358863X12442443
Zalawadiya SK, et al. Red Cell Distribution Width and Risk of Peripheral Artery Disease: Analysis of National Health and Nutrition Examination Survey 1999-2004. Vasc Med. 2012;17(3):155-63. PubMed PMID: 22615191.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Red cell distribution width and risk of peripheral artery disease: analysis of National Health and Nutrition Examination Survey 1999-2004. AU - Zalawadiya,Sandip K, AU - Veeranna,Vikas, AU - Panaich,Sidakpal S, AU - Afonso,Luis, PY - 2012/5/23/entrez PY - 2012/5/23/pubmed PY - 2012/10/12/medline SP - 155 EP - 63 JF - Vascular medicine (London, England) JO - Vasc Med VL - 17 IS - 3 N2 - Red cell distribution width (RDW) is an independent predictor of the 10-year estimated risk of coronary heart disease (CHD) events. However, RDW's association with peripheral artery disease (PAD) - a CHD risk equivalent - has not been evaluated to date. In this cross-sectional study, we examined 6950 participants of the National Health and Nutrition Examination Survey, 1999-2004. PAD was defined as an ankle-brachial index below 0.9 (n = 618). RDW was divided into quartiles (Q) (Q1: ≤ 12.2; Q2: 12.3-12.5; Q3: 12.6-13.0; Q4: ≥ 13.1) and PAD risk was compared across these quartiles using adjusted multivariate logistic regression. A graded increase in prevalent PAD with increasing RDW quartiles was observed (4.2% in Q1 vs 13.9% in Q4; test of trend p < 0.001). Risk of PAD was significantly higher (odds ratio (OR) 1.19, 95% confidence interval (CI): 1.06-1.34; p = 0.003) after adjusting for age, sex, race, body mass index, hypertension, hyperlipidemia, diabetes, smoking, estimated glomerular filtration rate, C-reactive protein, hemoglobin, mean corpuscular volume, and nutritional factors (folate, iron and vitamin B(12)) deficiencies with each unit (0.1) increase in RDW. Upon receiver-operating characteristics analysis, the predictive accuracy of the American College of Cardiology / American Heart Association (ACC/AHA)-defined PAD screening criteria (for a high-risk population) was 0.657 at best, but improved significantly (0.727) after addition of RDW (p < 0.0001). In conclusion, higher levels of RDW are independently associated with a higher risk of PAD and can significantly improve the risk prediction beyond that estimated by ACC/AHA-defined PAD screening criteria. SN - 1477-0377 UR - https://www.unboundmedicine.com/medline/citation/22615191/Red_cell_distribution_width_and_risk_of_peripheral_artery_disease:_analysis_of_National_Health_and_Nutrition_Examination_Survey_1999_2004_ L2 - https://journals.sagepub.com/doi/10.1177/1358863X12442443?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -