Assessing Red Blood Cell Distribution Width in Vietnamese Heart Failure Patients: A Cross-Sectional Study

Abstract

AbstractHeart failure (HF) is a growing public health concern, with red cell distribution width (RDW) gaining recognition as a cost-effective marker for predicting HF onset and progression. This study, conducted from February 2022 to February 2024 at Hue Central Hospital, aimed to assess RDW levels in hospitalized Vietnamese HF patients and its predictive value for HF severity, involving a cross-sectional analysis of 351 patients categorized into HF and non-HF groups. HF patients exhibited higher median RDW levels (14.90% [13.70% - 17.00%]) compared to non-HF individuals (13.10% [12.23% - 13.78%]). RDW was higher in HF patients with left ventricular ejection fraction (LVEF) < 50% (15.30%) than LVEF ≥ 50% (14.70%). ROC curve analysis for acute heart failure (AHF) prediction yielded an AUC of 0.651 (p < 0.001), with a cutoff point of 13.85%, sensitivity of 86.05%, and specificity of 36.94%. Elevated RDW levels were associated with HF risk (OR: 1.844, p < 0.001) and AHF (OR: 3.612, p < 0.001). Multivariate analysis identified associations between RDW and hemoglobin (Hb) (β = 2.431, p = 0.040) and hematocrit (HCT) (β = −3.355, p = 0.007) in HF. RBC and RDW > 13.85% were independent risk factors for AHF. This suggests that RDW levels can serve as biomarkers for diagnosing HF and predicting its severity. Their accessibility and cost-effectiveness indicate the potential utility of RDW in managing HF, particularly in settings with limited resources.