Predictive ability of red blood cell distribution width for negative remodeling of type B aortic dissection.

Abstract

To investigate the correlation between red blood cell distribution width (RDW) and negative remodeling (NR) in type B aortic dissection (TBAD). This study involved the retrospective analysis of clinical data of 264 patients with nonsurgical TBAD admitted to our hospital between September 2015 and September 2022. Patients underwent regular follow-up after discharge, including periodic chest and abdominal aortic computed tomography angiography. Aortic dissection false lumen expansion was evaluated based on computed tomography angiography images taken at the final follow-up. Patients were divided into two groups based on the occurrence of NR in aortic dissection: NR and non-NR groups. A total of 264 patients with an average age of 60 years (63.6% male), with a mean follow-up duration of 53.5 months and a survival rate of 87.9% (232/264 patients), were enrolled. During the follow-up period, 87 patients (33.0%) developed NR of the aortic dissection (NR group). Twenty-four patients in the NR group underwent surgery, which was significantly higher than the number of patients in the non-NR group (27.6% vs 16.9%). One patient in each group died of aortic rupture. RDW levels were significantly higher in the NR than the non-NR group (13.7 ± 1.2 vs 12.7 ± 1.0; P < .001). Spearman's correlation analysis identified a positive correlation between RDW and NR (r = 0.368; P < .001). Multivariate logistic regression analysis identified elevated RDW (odds ratio, 3.910; P < .001) as an independent risk factor for NR. The receiver operating characteristic curve indicated that a cutoff point of RDW >13.7% achieved an area under the curve for prediction of 0.770, sensitivity of 75.1%, and specificity of 93.2% (95% confidence interval, 0.722-0.818; P < .001). RDW is a simple, inexpensive, and effective predictive marker of NR in TBAD. Herein, we identified that an RDW of >13.7% is a risk factor for NR in patients with nonsurgical TBAD during follow-up. This limit may provide a reliable basis for assessing the need for surgical intervention, optimizing prognosis evaluation, and making clinical decisions, ultimately improving the long-term survival and quality of life of patients.