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J Acquir Immune Defic Syndr. 2017 Mar 1;74(3):298-302. doi: 10.1097/QAI.0000000000001231.

Brief Report: Elevated Red Cell Distribution Width Identifies Elevated Cardiovascular Disease Risk in Patients With HIV Infection.

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*Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH; †Division of Infectious Diseases and HIV Medicine, Department of Medicine, Center for AIDS Research, Case Western Reserve University/University Hospitals Cleveland Medical Center, Cleveland, OH; ‡Division of Medical Laboratory Science, School of Health and Rehabilitation Sciences, Ohio State University, Columbus, OH; §School of Medicine, Case Western Reserve University, Cleveland, OH; and ‖Section of Health Outcomes Research and Clinical Epidemiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH.


Red cell distribution width (RDW) is linked to cardiovascular risk in the general population, an association that might be driven by inflammation. Whether this relationship holds for patients with HIV infection has not been previously studied. Using a large clinical registry, we show that elevated RDW (>14.5%) is independently associated with increased risk of coronary artery disease {odds ratio [OR] 1.39 [95% confidence interval (CI): 1.25 to 1.55]}, peripheral vascular disease [OR 1.41 (95% CI: 1.29 to 1.53)], myocardial infarction [1.43 (95% CI: 1.25 to 1.63)], heart failure [OR 2.23 (95% CI: 1.99 to 2.49)], and atrial fibrillation [OR 1.96 (95% CI: 1.64 to 2.33)]. In conclusion, in the context of the inflammatory milieu that accompanies HIV infection, RDW remains a powerful marker of cardiovascular disease.

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