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BioMed Research International
Volume 2017 (2017), Article ID 5843702, 7 pages
Research Article

Red Cell Distribution Width Is Associated with All-Cause and Cardiovascular Mortality in Patients with Diabetes

1Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
2Department of Internal Medicine, Cardiovascular Medicine/Cardiac Electrophysiology, American University of Beirut Faculty of Medicine and Medical Center, Beirut, Lebanon
3Department of Diabetes, Hamad Medical Corporation, Doha, Qatar
4Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
5Department of Medicine and Genetic Medicine, Weill Cornell Medicine, Doha, Qatar

Correspondence should be addressed to Charbel Abi Khalil

Received 1 May 2017; Accepted 27 July 2017; Published 21 November 2017

Academic Editor: Yoshifumi Saisho

Copyright © 2017 Sadeer G. Al-Kindi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background and Methods. Red cell distribution width (RDW) has emerged as a prognostic marker in patients with cardiovascular diseases. We investigated mortality in patients with diabetes included in the National Health and Nutrition Examination Survey, in relation to baseline RDW. RDW was divided into 4 quartiles (Q1: ≤12.4%, Q2: 12.5%–12.9%, Q3: 13.0%–13.7%, and Q4: >13.7%). Results. A total of 3,061 patients were included: mean age years, 50% male, 39% White. Mean RDW was . Compared with first quartile (Q1) of RDW, patients in Q4 were more likely to be older, female, and African-American, have had history of stroke, myocardial infarction, and heart failure, and have chronic kidney disease. After a median follow-up of 6 years, 628 patient died (29% of cardiovascular disease). Compared with Q1, patients in Q4 were at increased risk for all-cause mortality (HR 3.44 [2.74–4.32], ) and cardiovascular mortality (HR 3.34 [2.16–5.17], ). After adjusting for 17 covariates, RDW in Q4 remained significantly associated with all-cause mortality (HR 2.39 [1.30–4.38], ) and cardiovascular mortality (HR 1.99 [1.17–3.37], ). Conclusion. RDW is a powerful and an independent marker for prediction of all-cause mortality and cardiovascular mortality in patients with diabetes.