Large variability in the size of red blood cells are associated with increased risk of several cardiovascular diseases, shows Jostein Lappegård’s PhD thesis.
MAIN RESULTS:
- High red blood cell distribution width is linked to increased risk of myocardial infarction and stroke.
- Progression of atherosclerosis is increased in persons with high red blood cell distribution width.
- Chronic inflammation is not the underlying cause of the association between red blood cell distribution width and cardiovascular disease.
THESIS DEFENCE:
Thesis: RedCell Distribution Width (RDW) and future risk of arterial cardiovascular diseases
Candidate: Jostein Lappegård
Time: May 28, 2018 at 12:15
Place: UiT The Arctic University of Norway, Farmasibygget: Tabletten
Link to university website (in Norwegian)
SUMMARY:
(1/2) A higher distribution width of red blood cells is associated with incident myocardial infarction and incident stroke. Red cell distribution width is a measure of the variability in size of circulating red blood cells.
Almost 26 000 participants in the Tromsø Study were followed for up to 15 years. There was a linear association between red cell distribution width and risk of both cardiovascular diseases, independent of anemia and traditional cardiovascular risk factors.
(3) Progression of atherosclerotic plaque was higher in participants with higher baseline distribution width of red blood cells, even after adjustment for traditional cardiovascular risk factors. Plaque was measured in 4677 participants of the Tromsø Study at baseline and after seven years of follow up.
(4) High-sensitivity C-reactive protein (hs-CRP) levels did not explain the associations between red cell distribution width and risk of myocardial infarction and ischemic stroke. The study includes 5765 individuals from Tromsø followed for up to 18 years. The risk estimates were only slightly attenuated after adjustments for hs-CRP, suggesting that higher red cell distribution width is not a mediator in the causal pathway between chronic inflammation and cardiovascular disease.
REFERENCES:
(1) Skjelbakken, T., Lappegård, J., Ellingsen, T. S., Barrett-Connor, E., Brox, J., Løchen, M. L., Njølstad, I., Wilsgaard, T., Mathiesen, E. B., Brækkan, S. K., & Hansen, J. B. (2014). Red cell distribution width is associated with incident myocardial infarction in a general population: the Tromsø Study. Journal of the American Heart Association, 3(4), e001109.
(2) Lappegård, J., Ellingsen, T. S., Skjelbakken, T., Mathiesen, E. B., Njølstad, I., Wilsgaard, T., Brox, J., Brækkan, S. K., & Hansen, J. B. (2015). Red cell distribution width is associated with future risk of incident stroke. Thrombosis and haemostasis.
(3) Lappegård, J., Ellingsen, T. S., Vik, A., Skjelbakken, T., Brox, J., Mathiesen, E. B., Johnsen, S. H., Brækkan, S. K., & Hansen, J. B. (2015). Red cell distribution width and carotid atherosclerosis progression. Thrombosis and Haemostasis, 113(3), 649-654.
(4) Lappegård, J., Ellingsen, T. S., Hindberg, K., Mathiesen, E. B., Njølstad, I., Wilsgaard, T., Løchen, M.-L., Brækkan, S. K., & Hansen, J. B. (2018). Impact of Chronic Inflammation, Assessed by hs-CRP, on the Association between Red Cell Distribution Width and Arterial Cardiovascular Disease: The Tromsø Study. TH Open, 2(02), e182-e189.
