Previous studies have reported that in patients with heart failure, an increased value of red cell distribution width (RDW) is a prognostic biomarker associated with poor outcome especially long-term mortality.

To evaluate the prognostic value of RDW in risk stratification of patients with chronic heart failure (CHF) in our heart failure unit.

We conducted a cross-sectional monocentric study in the Casablanca heart failure unit from December 2010 to March 2017 including all the outpatients with CHF. On inclusion, the RDW was measured and clinical, biochemical, and echocardiographic variables were studied.

In total, 4207 patients were included (median age 65 years [52–78]), 65% were male, mean left ventricular ejection fraction (LVEF) was 32,4%. In total, 203 required hospitalization for heart failure (HF) decompensation. High probability of hospitalization for HF was showed in the group with RDW >15 quartiles (P=0.003). This predictive value was independent of other covariates such us anemia.

RDW is an independent risk marker and adds prognostic value in outpatients with chronic heart failure. These results suggest that this biological marker should be included in the initial management of these patients.