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Red blood cell distribution width, relative lymphocyte count, and type 2 diabetes mellitus predict all-cause mortality in patients with advanced heart failure.

Red blood cell distribution width, relative lymphocyte count, and type 2 diabetes mellitus predict all-cause mortality in patients with advanced heart failure.
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Szyguła-Jurkiewicz B, Siedlecki Ł, Pyka Ł, Romuk E, Przybyłowski P, Gąsior M,


Szyguła-Jurkiewicz B, Siedlecki Ł, Pyka Ł, Romuk E, Przybyłowski P, Gąsior M, (click to view)

Szyguła-Jurkiewicz B, Siedlecki Ł, Pyka Ł, Romuk E, Przybyłowski P, Gąsior M,

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Polish archives of internal medicine 2017 11 09() doi 10.20452/pamw.4149
Abstract

INTRODUCTION    Early identification of patients with advanced heart failure (HF) who are at a higher risk for poor outcome is an important element of patient management, both from the medical and the economic point of view. OBJECTIVES    In the present study, we sought to determine the association between hematologic parameters assessed on admission and within the 3-year mortality period in patients consecutively admitted with advanced HF.  We also investigated the association between baseline demographic and clinical data and mortality.  PATIENTS AND METHODS    We analyzed the data related to consecutive patients with advanced HF from the COMMIT-HF, which is a single center registry. Patients with hematologic and autoimmune disorders, acute or chronic inflammatory diseases, malignant diseases, incomplete clinical and laboratory data, and those receiving glucocorticoids were excluded from the study. RESULTS    We analyzed 785 patients with advanced HF out of the total number of 1,798 patients entered into the COMMIT-HF registry between 2009 and 2013. The average age of the patients was 61.9 (12.4) years and 76.8% of them were male. DM [HR 1.461 (95%Cl 1.146-1.863); P = 0.002], RDW [HR 1.054 (95%Cl 1.037-1.071); P <0.0001] and RLC% [HR 0.942 (95%Cl 0.928-0.956) P <0.0001] constituted independent factors affecting death. CONCLUSIONS    The present study shows that DM is a strong independent predictor of death in the analyzed group of patients. A high red blood cell distribution width and a low relative lymphocyte count are simple, accurate, and widely available markers predicting mortality in advanced HF patients during a three year follow-up.

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