Red Blood Cell Distribution Width (RDW) and Its Effect on Survival in Patients with Pulmonary Arterial Hypertension (PAH) and Chronic Thromboembolic Pulmonary Hypertension (CTEPH)

INTRODUCTION: Red blood cell distribution width (RDW) has been reported as a predictive value of morbidity and mortality in many cardiovascular diseases. It is, however, unclear what the relationship is between RDW levels and survival in patients with PAH and CTEPH. We aimed to evaluate the RDW level in these patient groups, and to measure its relationship with mortality.


METHODS: Between 2018 and 2023, 170 patients followed up in a PAH center were retrospectively evaluated. Demographic information of the patients and RDW levels at the time of diagnosis were obtained from the hospital automation system. Blood-brain natriuretic peptide (BNP) levels, functional class level (WHO-FS) and systolic pulmonary artery pressure values were recorded. Patient follow-up times and survival were recorded from the hospital automation system.

RESULTS: Among the patients, 53 were male (31.2%), and 117 were female (68.8%). The number of PAH patients was 116(68.2%), and the number of CTEPH patients was 54(31.7%). During this period, 24.7%(n: 42) of the patients died. Statistical significance was found in RDW and BNP values when descriptive statistics were evaluated according to survival. RDW and BNP values were higher in patients who died (RDW: p=0.008, OR: 1.006- BNP: p=0.021, OR: 0,998). Clinical, functional class values of the patients were also positively correlated with RDW and BNP values (p<0.002-p<0.001). Patients with high functional class had poor survival (p=0.000).

DISCUSSION AND CONCLUSION: In addition to known factors such as functional class level and BNP,RDW can be used as a potential biomarker for predicting survival in patients with PAH and CTEPH