High red blood cell distribution width and preclinical carotid atherosclerosis.

Background: Preclinical carotid atherosclerosis is associated with future risk of stroke. Data regarding the correlation between carotid atherosclerosis and biomarkers, which might predict the risk for the disease has been inconsistent and conflicting. Red blood cell distribution width (RDW) is also related to adverse clinical outcomes. Studies examining the relationship between RDW and preclinical and clinical carotid atherosclerosis were non-conclusive.

Objective: To study the association between RDW and preclinical carotid atherosclerosis in a large heterogeneous cohort.

Methods: Patients underwent Doppler ultrasound of the common carotid artery and Carotid Intima Media Thickness (CIMT). Advanced CIMT software analyzed over 100 samples in each exam. Blood samples for RDW were obtained on the same day. Logistic regression was used to evaluate the correlation between RDW and preclinical carotid atherosclerosis.

Results: Five hundred and twenty-two consecutive patients were included, with a mean age of 6.6 ± 11. A cut-off value of 14.1% was used to differentiate between high and low RDW groups. The higher RDW group (RDW above 14.1%) was significantly older and with more cardiovascular risk factors. In a multivariate analysis, in all the patients including those treated by lipid modifying therapies, high RDW was significantly associated with advanced CIMT (OR = 2.35, CI 95% 1.28-4.30, p = 0.006). This association remained significant in subgroups of non-diabetic patients as well as patients not treated by lipid modifying drugs. RDW was also associated with significant carotid artery stenosis (OR = 1.77, CI 95% 1.12-2.82, p = 0.015).

Conclusions: High RDW correlates with increased risk for preclinical and clinical carotid atherosclerosis.