Red blood cell distribution width and maximum left ventricular wall thickness predict poor outcomes in patients with hypertrophic cardiomyopathy.

Aim: To evaluate the prognostic utility of red blood cell distribution width (RDW) and maximum left ventricular wall thickness (MLVWT) in patients with hypertrophic cardiomyopathy (HCM). Patients and methods: This study is a retrospective cohort analysis. Patients diagnosed with HCM at the First Affiliated Hospital of Sun Yat‐sen University from March 2014 to March 2019 were included. HCM patients were stratified into two groups based on the occurrence of major adverse cardiac events (MACE). Receiver operating characteristic (ROC) curves were then constructed and Cox regression models were employed to gauge the prognostic relevance of RDW and MLVWT for HCM patients. Kaplan–Meier analysis evaluated the survival and MACE‐free rate in patients with different level of RDW and MLVWT. Results: A total of 300 patients with HCM were enrolled in this study and followed up for 40.56±18.33 months. Among them, 117 MACE (39.00%), 40 all‐cause deaths (13.33%), and 29 cardiovascular deaths (9.67%). The level of RDW, MLVWT, creatinine (Cr), and B‐type pro‐brain natriuretic peptide (NT‐ProBNP) were statistically different between the MACE group and non‐MACE group (P <.05). Multivariate analysis showed that after adjusting for confounding factors, RDW and MLVWT were independent predictors of all‐cause mortality and MACE in HCM patients. ROC showed that RDW >.13 and MLVWT > 23 mm are the cut‐off value to predict all‐cause mortality and MACE. The area under the ROC curve AUC of the combination predicting the occurrence of all‐cause mortality and MACE are.823 and.820, respectively. Kaplan–Meier analysis showed that the survival rate and MACE‐free survival rate of group 1 (RDW≦.13 and MLVWT≦23 mm) were significantly higher than group 2 (RDW >.13 or MLVWT > 23 mm), and group 3 (RDW >.13 and MLVWT > 23 mm) (P =.000). Conclusion: We determined that increased RDW and MLVWT was independently associated with MACE incidence and risk of mortality in HCM patients. Combined evaluation of RDW and MLVWT yielded a more accurate predictive model of HCM patient outcomes relative to the use of either of these metrics in isolation. Our research can provide a theoretical basis in the occurrence of MACE for the high‐risk HCM and intervene them properly and timely. [ABSTRACT FROM AUTHOR]

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