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Thromb Haemost 2015; 113(03): 649-654
DOI: 10.1160/TH14-07-0606
Atherosclerosis and Ischaemic Disease
Schattauer GmbH

Red cell distribution width and carotid atherosclerosis progression The Tromsø Study

Jostein Lappegård
1   K.G.Jebsen Thrombosis Research and Expertise Centre, Department of Clinical Medicine, University of Tromsø, Norway
2   Hematological Research Group (HERG), Department of Clinical Medicine, University of Tromsø, Norway
,
Trygve S. Ellingsen
1   K.G.Jebsen Thrombosis Research and Expertise Centre, Department of Clinical Medicine, University of Tromsø, Norway
2   Hematological Research Group (HERG), Department of Clinical Medicine, University of Tromsø, Norway
,
Anders Vik
1   K.G.Jebsen Thrombosis Research and Expertise Centre, Department of Clinical Medicine, University of Tromsø, Norway
2   Hematological Research Group (HERG), Department of Clinical Medicine, University of Tromsø, Norway
3   Division of Internal Medicine, University Hospital of North-Norway, Tromsø, Norway
,
Tove Skjelbakken
1   K.G.Jebsen Thrombosis Research and Expertise Centre, Department of Clinical Medicine, University of Tromsø, Norway
2   Hematological Research Group (HERG), Department of Clinical Medicine, University of Tromsø, Norway
3   Division of Internal Medicine, University Hospital of North-Norway, Tromsø, Norway
,
Jan Brox
1   K.G.Jebsen Thrombosis Research and Expertise Centre, Department of Clinical Medicine, University of Tromsø, Norway
4   Department of Laboratory Medicine, University Hospital of North-Norway, Tromsø, Norway
,
Ellisiv B. Mathiesen
1   K.G.Jebsen Thrombosis Research and Expertise Centre, Department of Clinical Medicine, University of Tromsø, Norway
5   Brain and Circulation Research Group, Department of Clinical Medicine, University of Tromsø, Norway
6   Department of Neurology and Neurophysiology, University Hospital of North-Norway, Tromsø, Norway
,
Stein Harald Johnsen
5   Brain and Circulation Research Group, Department of Clinical Medicine, University of Tromsø, Norway
6   Department of Neurology and Neurophysiology, University Hospital of North-Norway, Tromsø, Norway
,
Sigrid K. Brækkan
1   K.G.Jebsen Thrombosis Research and Expertise Centre, Department of Clinical Medicine, University of Tromsø, Norway
2   Hematological Research Group (HERG), Department of Clinical Medicine, University of Tromsø, Norway
3   Division of Internal Medicine, University Hospital of North-Norway, Tromsø, Norway
,
John-Bjarne Hansen
1   K.G.Jebsen Thrombosis Research and Expertise Centre, Department of Clinical Medicine, University of Tromsø, Norway
2   Hematological Research Group (HERG), Department of Clinical Medicine, University of Tromsø, Norway
3   Division of Internal Medicine, University Hospital of North-Norway, Tromsø, Norway
› Author Affiliations Financial support: K. G. Jebsen- Thrombosis Research and Expertise Centre (TREC) is supported by an independent grant from the K. G. Jebsen Foundation. SKB and JBH have received research grants from the Northern Norway Regional Health Authority (URL: http://www.helse-nord.no/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Further Information

Publication History

Received: 15 July 2014

Accepted after major revision: 13 January 2014

Publication Date:
17 November 2017 (online)

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Summary

Red cell distribution width (RDW), a measure of the size variability of circulating erythrocytes, is associated with cardiovascular morbidity and mortality. We aimed to investigate whether RDW was associated with progression of atherosclerotic plaques in subjects recruited from the general population. Baseline characteristics, including RDW, were collected from 4677 participants in the fourth survey of the Tromsø Study conducted in 1994/95. Prevalence of carotid plaques and total plaque area (TPA) were assessed by ultrasonographic imaging at baseline and after seven years of follow-up. Generalised linear models were used to analyse change in TPA across tertiles of RDW. Change in TPA was significantly higher across tertiles of RDW in crude analysis and in multivariable analysis adjusted for cardiovascular risk factors. The mean change in TPA increased from 5.6 mm2 (4.9–6.4) in tertile 1 (RDW ≤ 12.6 %) to 6.7 mm2 (5.9–7.6) in tertile 3 (RDW ≥ 13.3) in multivariable analysis adjusted for body mass index, total cholesterol, HDL cholesterol, systolic blood pressure, self-reported diabetes, smoking status, platelet count, white blood cell count, and hs-CRP levels (p for trend 0.003). A 1 % increase in RDW was associated with 0.6 mm2 (0.1–1.2) increase in TPA in multivariable analysis (p=0.03). RDW was associated with progression of atherosclerosis after adjustments for traditional atherosclerotic risk factors. Our findings suggest that the link between RDW and cardiovascular morbidity and mortality may be explained by atherosclerosis.

Keywords

Atherosclerosis - cardiovascular disease - cohort studies - epidemiology - erythrocyte indices
 

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