Red cell distribution width is associated with future risk of incident stroke

Jostein Lappegård; Trygve S. Ellingsen; Tove Skjelbakken; Ellisiv B. Mathiesen; Inger Njølstad; Tom Wilsgaard; Jan Brox; Sigrid K. Brækkan; John-Bjarne Hansen

doi:10.1160/TH15-03-0234

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2016; 115(01): 126-134
DOI: 10.1160/TH15-03-0234

Stroke, Systemic or Venous Thromboembolism

Schattauer GmbH Schattauer

Red cell distribution width is associated with future risk of incident stroke

The Tromsø Study

Authors

Jostein Lappegård

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Norway

²Hematological Research Group (HERG), Department of Clinical Medicine, UiT The Arctic University of Norway, Norway
Trygve S. Ellingsen

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Norway

²Hematological Research Group (HERG), Department of Clinical Medicine, UiT The Arctic University of Norway, Norway
Tove Skjelbakken

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Norway

²Hematological Research Group (HERG), Department of Clinical Medicine, UiT The Arctic University of Norway, Norway

³Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
Ellisiv B. Mathiesen

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Norway

⁴Brain and Circulation Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Norway

⁵Department of Neurology and Neurophysiology, University Hospital of North Norway, Tromsø, Norway
Inger Njølstad

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Norway

⁶Department of Community Medicine, UiT The Arctic University of Norway, Norway
Tom Wilsgaard

⁶Department of Community Medicine, UiT The Arctic University of Norway, Norway
Jan Brox

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Norway

²Hematological Research Group (HERG), Department of Clinical Medicine, UiT The Arctic University of Norway, Norway

⁷Department of Clinical Chemistry, University Hospital of North Norway, Tromsø, Norway
Sigrid K. Brækkan

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Norway

²Hematological Research Group (HERG), Department of Clinical Medicine, UiT The Arctic University of Norway, Norway

³Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
John-Bjarne Hansen

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Norway

²Hematological Research Group (HERG), Department of Clinical Medicine, UiT The Arctic University of Norway, Norway

³Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway

Abstract

Summary

Red cell distribution width (RDW), a measure of the variability in size of the circulating erythrocytes, is associated with cardiovascular morbidity and mortality. We aimed to investigate whether RDW was associated with incident stroke and case fatality in subjects recruited from the general population. Baseline characteristics were obtained from 25,992 subjects participating in the fourth survey of the Tromsø Study, conducted in 1994/95. Incident stroke was registered from inclusion until December 31, 2010. Cox regression models were used to calculate hazard ratios (HR) with 95 % confidence intervals (95 % CI) for stroke, adjusted for age, sex, body mass index, smoking, haemoglobin level, white blood cell count, thrombocyte count, hypertension, total cholesterol, triglycerides, self-reported diabetes, and red blood cell count. During a median follow-up of 15.8 years, 1152 participants experienced a first-ever stroke. A 1 % increment in RDW yielded a 13 % higher risk of stroke (multivariable HR: 1.13, 95 % CI: 1.07–1.20). Subjects with RDW in the highest quintile compared to the lowest had a 37 % higher risk of stroke in multivariable analysis (HR: 1.37, 95 % CI: 1.11–1.69). Subjects with RDW above the 95-percentile had 55 % higher risk of stroke compared to those in the lowest quintile (HR: 1.55, 95 % CI: 1.16–2.06). All risk estimates remained unchanged after exclusion of subjects with anaemia (n=1102). RDW was not associated with increased risk of death within one year or during the entire follow-up after an incident stroke. RDW is associated with incident stroke in a general population, independent of anaemia and traditional atherosclerotic risk factors.

Keywords

Epidemiological studies - stroke - risk factors

Full Text

References

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