1
|
Tadesse S, Gudina EK, Yilma D, Asefa ET, Yemane T, Mossie A. Haematological Indices in Acute Coronary Syndrome Patients in Ethiopia: A Comparative Cross-Sectional Study. J Blood Med 2024; 15:275-284. [PMID: 38912419 PMCID: PMC11193461 DOI: 10.2147/jbm.s457371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 06/12/2024] [Indexed: 06/25/2024] Open
Abstract
Background Numerous biomarkers are used as diagnostic, prognostic, and predictive indicators of myocardial ischemia. The most commonly used biomarkers are cardiac troponin I (Tn-I) and creatinine kinase (CK-MB). However, in developing nations, their availability in primary care settings is extremely limited. In such situations, easily available assays such as complete blood count (CBC) should be investigated as prognostic indicators in individuals with acute coronary syndrome (ACS). Objective This study aimed to compare the pattern of haematological indices and blood cell ratios of ACS patients compared with apparently healthy controls. Methods Patients diagnosed with ACS were recruited consecutively between 01 May 2022 and 31 October 2023 at Jimma Medical Center (JMC). Biochemical analyses and complete blood counts were performed. Analysis of variance was performed to compare the continuous variables. Spearman correlation coefficient tests were performed to correlate hematologic parameters with high sensitive troponin-I (hs-Tn-I) levels. Results This study enrolled 220 participants (110 patients with ACS and age, sex, and place of residence matched 110 non-ACS controls). From ACS group 99 (90%) were diagnosed with ST-elevated myocardial infarction. The ACS group had a significantly greater mean platelet volume (MPV), white blood cell count, red cell distribution width (RDW), neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio. The RDW (r = 0.248, p = 0.009) and MPV (r = 0.245, p = 0.009) were significantly positively correlated with hs-Tn-I levels in the ACS group. MPV, RDW, and monocyte count were significantly higher in non-survivor ACS patients (p <0.05). Conclusion The significant differences observed in haematological parameters between individuals with ACS and healthy controls suggest the potential utility of these easily accessible and cost-effective diagnostics in predicting future morbidity and ACS risk. Incorporating these routine evaluations into clinical practice could enhance risk assessment and improve patient outcomes.
Collapse
Affiliation(s)
- Samuel Tadesse
- Department of Biomedical Sciences, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Esayas Kebede Gudina
- Department of Internal Medicine, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Daniel Yilma
- Department of Internal Medicine, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Elsah Tegene Asefa
- Department of Internal Medicine, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Tilahun Yemane
- Department of Medical Laboratory, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Andualem Mossie
- Department of Biomedical Sciences, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| |
Collapse
|
2
|
Ruan L, Xu S, Qin Y, Tang H, Li X, Yan G, Wang D, Tang C, Qiao Y. Red Blood Cell Distribution Width to Albumin Ratio for Predicting Type I Cardiorenal Syndrome in Patients with Acute Myocardial Infarction: A Retrospective Cohort Study. J Inflamm Res 2024; 17:3771-3784. [PMID: 38882186 PMCID: PMC11180445 DOI: 10.2147/jir.s454904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/29/2024] [Indexed: 06/18/2024] Open
Abstract
Purpose Red blood cell distribution width to albumin ratio (RAR) is a novel inflammatory biomarker that independently predicts adverse cardiovascular events and acute kidney injury. This study aimed to assess the predictive value of RAR for cardio-renal syndrome type I (CRS-I) risk in acute myocardial infarction (AMI) patients. Patients and methods This study retrospectively enrolled 551 patients who were definitively diagnosed as AMI between October 2021 and October 2022 at the Affiliated Zhongda Hospital of Southeast University. Participants were divided into two and four groups based on the occurrence of CRS-I and the quartiles of RAR, respectively. Demographic data, laboratory findings, coronary angiography data, and drug utilization were compared among the groups. Logistic regression and receiver operating characteristic curve (ROC) analysis were performed to identify independent risk factors for CRS-I and evaluated the predictive value of RAR for CRS-I. Results Among the cohort of 551 patients, 103 (18.7%) developed CRS-I. Patients with CRS-I exhibited significantly elevated RAR levels compared to those without the condition, and the incidence of CRS-I correlated with escalating RAR. Univariate and multivariate logistic regression analyses identified RAR as an independent risk factor for CRS-I. ROC curves analysis demonstrated that RAR alone predicted CRS-I with an area under the curve (AUC) of 0.683 (95% CI=0.642-0.741), which was superior to the traditional inflammatory marker C-reactive protein (CRP). Adding the variable RAR to the model for predicting the risk of CRS-I further improved the predictive value of the model from 0.808 (95% CI=0.781-0.834) to 0.825 (95% CI=0.799-0.850). Conclusion RAR is an independent risk factor for CRS-I, and high levels of RAR are associated with an increased incidence of CRS-I in patients with AMI. RAR emerges as a valuable and readily accessible inflammatory biomarker that may play a pivotal role in risk stratification in clinical practice.
Collapse
Affiliation(s)
- Liang Ruan
- School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Shuailei Xu
- School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Yuhan Qin
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Huihong Tang
- School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Xudong Li
- School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Gaoliang Yan
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Dong Wang
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Chengchun Tang
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Yong Qiao
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, People's Republic of China
| |
Collapse
|
3
|
Lan W, Liu E, Sun D, Li W, Zhu J, Zhou J, Jin M, Jiang W. Red cell distribution in critically ill patients with chronic obstructive pulmonary disease. Pulmonology 2024; 30:34-42. [PMID: 35501276 DOI: 10.1016/j.pulmoe.2022.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Red blood cell distribution width (RDW) is associated with increased mortality risk in patients with chronic obstructive pulmonary disease (COPD). However, limited data are available for critically ill patients with COPD. METHODS Data from the Medical Information Mart for Intensive Care III V1.4 database were analyzed in this retrospective cohort research. The International Classification of Diseases codes were used to identify critically ill patients with COPD. The first value of RDW was extracted within the first 24 h after intensive care unit admission. The endpoint was 28-day all-cause mortality. Multivariable logistic regression analysis was performed to examine the relationship between RDW and 28-day mortality. Age, sex, ethnicity, anemia status, comorbidities, clinical therapy, and disease severity score were considered for subgroup analysis. RESULTS A total of 2,344 patients were included with mean (standard deviation) age of 72.3 (11.3) years, in which 1,739 (53.6%) patients were men. The increase in RDW was correlated with an increased risk of 28-day mortality in the multivariate logistic regression model (odds ratio [OR] 1.15; 95% confidence interval [CI] 1.09-1.21). In comparison with the low-RDW group, the middle and high-RDW groups tended to have higher risks of 28-day all-cause mortality (OR [95% CI] 1.03 [0.78-1.34]; OR [95% CI] 1.70 [1.29-2.22]; P trend < 0.0001). Subgroup analyses show no evidence of effect modifications on the correlation of RDW and 28-day all-cause mortality. CONCLUSION An increase in RDW was associated with an increased risk of 28-day all-cause mortality in critically ill patients with COPD. Further studies are required to investigate this association.
Collapse
Affiliation(s)
- W Lan
- Department of Respiratory and Critical Care Medicine, Lishui Municipal Central Hospital, Lishui, Zhejiang 323000, China
| | - E Liu
- Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory for Accurate Diagnosis and Treatment of Chronic Liver Disease, Wenzhou, Zhejiang 325000, China
| | - D Sun
- Department of Respiratory and Critical Care Medicine, Lishui Municipal Central Hospital, Lishui, Zhejiang 323000, China
| | - W Li
- Department of Respiratory and Critical Care Medicine, Lishui Municipal Central Hospital, Lishui, Zhejiang 323000, China
| | - J Zhu
- Department of Cardiology, Lishui Hospital, Zhejiang University School of Medicine, Lishui, Zhejiang 323000, China
| | - J Zhou
- Department of Pathology, Lishui Hospital, Zhejiang University School of Medicine, Lishui, Zhejiang 323000, China
| | - M Jin
- Department of Internal Medicine, Yunhe People's Hospital, Yunhe, Zhejiang 323600, China
| | - W Jiang
- Department of Gastroenterology, Lishui Municipal Central Hospital, Lishui, Zhejiang 323000, China.
| |
Collapse
|
4
|
Martins CMDH, Monteiro Júnior JGDM, Torres DDOC, Sobral Filho DC, Morais MCS, Montarroyos UR, Silva IKD, Santos ACOD. Hematological Changes during Seven Days of Hospitalization in Patients with Acute Myocardial Infarction. Arq Bras Cardiol 2023; 120:e20230045. [PMID: 37937582 DOI: 10.36660/abc.20230045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/16/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Acute myocardial infarction is a major cause of mortality worldwide, and atherosclerotic plaque formation is the main pathophysiological mechanism, which results in chronic inflammation that induces erythrocyte maturation and may cause an increase in the red cell distribution width (RDW) index. OBJECTIVE Evaluate the role of the anisocytosis index in patients with acute myocardial infarction in both types of infarctions as a predictor of severity. METHODS Patients were included in the study according to the inclusion/exclusion criteria, following the hospital routine based on their clinical and laboratory history. Statistical analyzes were performed according to each variable. All conclusions were drawn considering the significance level of 5%. RESULTS During the follow-up period, in the 349 patients analyzed, the mortality rate was associated with the variables RDW (CV) and RDW (SD), in those patients who died, an increase was noted, as demonstrated in the multivariate model, for the effects of an acute ST elevation myocardial infarction and the RDW, adjusted for confounding factors (p-value = 0.03 and 0.04). In contrast, the total number of erythrocytes (p-value = 0.00) and hemoglobin (p-value = 0.03) showed a decrease during severe patients' hospitalization. CONCLUSION The anisocytosis index was a predictive factor of mortality and can be used as an indicator of worse prognosis in patients with acute myocardial infarction.
Collapse
Affiliation(s)
| | - José Gildo de Moura Monteiro Júnior
- Pronto Socorro Cardiológico de Pernambuco (PROCAPE-UPE), Recife, PE - Brasil
- Faculdade de Ciências Médicas - Universidade de Pernambuco (FCM-UPPE), Recife, PE - Brasil
| | | | - Dario Celestino Sobral Filho
- Pronto Socorro Cardiológico de Pernambuco (PROCAPE-UPE), Recife, PE - Brasil
- Faculdade de Ciências Médicas - Universidade de Pernambuco (FCM-UPPE), Recife, PE - Brasil
| | | | | | | | | |
Collapse
|
5
|
Chen W, Tan X, Du X, Li Q, Yuan M, Ni H, Wang Y, Du J. Prediction models for major adverse cardiovascular events following ST-segment elevation myocardial infarction and subgroup-specific performance. Front Cardiovasc Med 2023; 10:1181424. [PMID: 37180806 PMCID: PMC10167292 DOI: 10.3389/fcvm.2023.1181424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/27/2023] [Indexed: 05/16/2023] Open
Abstract
Background ST-segment elevation myocardial infarction (STEMI) patients are at a high residual risk of major adverse cardiovascular events (MACEs) after revascularization. Risk factors modify prognostic risk in distinct ways in different STEMI subpopulations. We developed a MACEs prediction model in patients with STEMI and examined its performance across subgroups. Methods Machine-learning models based on 63 clinical features were trained in patients with STEMI who underwent PCI. The best-performing model (the iPROMPT score) was further validated in an external cohort. Its predictive value and variable contribution were studied in the entire population and subgroups. Results Over 2.56 and 2.84 years, 5.0% and 8.33% of patients experienced MACEs in the derivation and external validation cohorts, respectively. The iPROMPT score predictors were ST-segment deviation, brain natriuretic peptide (BNP), low-density lipoprotein cholesterol (LDL-C), estimated glomerular filtration rate (eGFR), age, hemoglobin, and white blood cell (WBC) count. The iPROMPT score improved the predictive value of the existing risk score, with an increase in the area under the curve to 0.837 [95% confidence interval (CI): 0.784-0.889] in the derivation cohort and 0.730 (95% CI: 0.293-1.162) in the external validation cohort. Comparable performance was observed between subgroups. The ST-segment deviation was the most important predictor, followed by LDL-C in hypertensive patients, BNP in males, WBC count in females with diabetes mellitus, and eGFR in patients without diabetes mellitus. Hemoglobin was the top predictor in non-hypertensive patients. Conclusion The iPROMPT score predicts long-term MACEs following STEMI and provides insights into the pathophysiological mechanisms for subgroup differences.
Collapse
Affiliation(s)
- Weiyao Chen
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
- Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Collaborative Innovation Centre for Cardiovascular Disorders, Beijing, China
| | - Xin Tan
- Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Collaborative Innovation Centre for Cardiovascular Disorders, Beijing, China
| | - Xiaoyu Du
- Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Collaborative Innovation Centre for Cardiovascular Disorders, Beijing, China
- Center for Cardiovascular Medicine, The First Hospital of Jilin University, Changchun, China
| | - Qin Li
- Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Collaborative Innovation Centre for Cardiovascular Disorders, Beijing, China
| | - Meng Yuan
- Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Collaborative Innovation Centre for Cardiovascular Disorders, Beijing, China
| | - Hui Ni
- Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Collaborative Innovation Centre for Cardiovascular Disorders, Beijing, China
| | - Yuan Wang
- Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Collaborative Innovation Centre for Cardiovascular Disorders, Beijing, China
| | - Jie Du
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
- Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Collaborative Innovation Centre for Cardiovascular Disorders, Beijing, China
| |
Collapse
|
6
|
Zhai R, Chen X, Wang G, Xu J, Yang Y. Predictive Value of Red Cell Distribution Width in the Diagnosis of Peripherally Inserted Central Catheter (PICC)-Related Thrombosis Among Cancer Patients. Int J Gen Med 2023; 16:359-365. [PMID: 36747971 PMCID: PMC9899010 DOI: 10.2147/ijgm.s395745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/17/2023] [Indexed: 02/03/2023] Open
Abstract
Purpose This study aimed to investigate the predictive value of red cell distribution width (RDW) in patients with peripherally inserted central catheter (PICC)-related thrombosis. Patients and methods This was a case‒control study. A total of 98 cancer patients undergoing PICC placement from January 2017 to December 2019 at the ICU Venous Access Center of Peking University Cancer Hospital were retrospectively analyzed. These included 47 cases in the thrombosis group and 51 cases in the nonthrombosis group according to the occurrence of PICC-related thrombosis within 90 days after the PICC procedure. Results a) RDW was significantly higher in the thrombosis group (15.98±1.93) than in the nonthrombosis group (13.98±1.09). Additionally, the number of smoking histories in the thrombosis group (18, 38.30%) was significantly higher than that in the nonthrombosis group (5, 9.80%). b) Logistic regression analysis indicated that RDW and smoking history were independent risk factors for PICC-related thrombosis (OR: 3.028, P<0.001; OR: 5.640, P=0.023). c) The area under the receiver operating characteristic (ROC) curve of the combination of RDW and smoking history was 86.8%, and the sensitivity and specificity for predicting thrombosis after PICC were 85.1% and 80%, respectively. d) Cox regression analysis revealed that RDW and smoking history were independent risk factors for PICC-related thrombosis (p<0.001). e) Results from Kaplan‒Meier analysis showed that incidence of PICC-related thrombosis in patients with RDW less than 14.75% is significantly lower than those with RDW 14.75% and above (p<0.001). e) Baseline RDW was not different between the two groups (P>0.05), ΔRDW was significantly different between the two groups (p<0.001). Conclusion The combined use of RDW and smoking history has early evaluation and predictive value in the diagnosis of PICC-related thrombosis.
Collapse
Affiliation(s)
- Rui Zhai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Critical Care Medicine, Peking University Cancer Hospital & Institute, Beijing, People’s Republic of China
| | - Xiaojie Chen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Critical Care Medicine, Peking University Cancer Hospital & Institute, Beijing, People’s Republic of China
| | - Guodong Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Critical Care Medicine, Peking University Cancer Hospital & Institute, Beijing, People’s Republic of China
| | - Jiaxuan Xu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Critical Care Medicine, Peking University Cancer Hospital & Institute, Beijing, People’s Republic of China
| | - Yong Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Critical Care Medicine, Peking University Cancer Hospital & Institute, Beijing, People’s Republic of China,Correspondence: Yong Yang, Peking University Cancer Hospital & Institute, No. 52 of Fucheng Road, Haidian District, Beijing, 100142, People’s Republic of China, Tel +86-10-88197798, Email
| |
Collapse
|
7
|
RDW as A Predictor for No-Reflow Phenomenon in DM Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. J Clin Med 2023; 12:jcm12030807. [PMID: 36769459 PMCID: PMC9917933 DOI: 10.3390/jcm12030807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/07/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND No-reflow phenomenon (NRP) in ST-segment elevation myocardial infarction (STEMI) patients is not infrequent. The predictive value of red blood-cell distribution width (RDW) on NRP has not been explored. METHODS STEMI patients undergoing primary percutaneous coronary intervention (pPCI) were enrolled. Plasma samples were obtained at admission. Participants were divided into two groups according to RDW. Logistic regression and receiver operating characteristic (ROC) curve were performed to evaluate the relationship between RDW and NRP. Subgroup analysis was made between the diabetes mellitus (DM) group and the No-DM group. RESULTS The high RDW group had a higher NRP compared to the low group. In multivariate logistic regression analysis, DM (adjusted odds ratio [AOR]:1.847; 95% confidence interval [CI]: 1.209-2.822; p = 0.005) and hemoglobin (AOR: 0.986; 95% CI: 0.973-0.999; p < 0.05), other than RDW, were independent predictors of NRP. RDW (AOR: 2.679; 95% CI: 1.542-4.655; p < 0.001) was an independent predictor of NRP in the DM group, but not in the No-DM group. In the DM group, area under the ROC curve value for RDW predicting NRP was 0.707 (77.3% sensitivity, 56.3% specificity (p < 0.001)). CONCLUSIONS RDW is a predictor of NRP in DM patients with STEMI, which provides further assistance in clinicians' decision making.
Collapse
|
8
|
Ebina T, Tochihara S, Okazaki M, Koike K, Tsuto Y, Tayama M, Takanami Y, Hirose H, Horii M, Okada K, Matsuzawa Y, Maejima N, Iwahashi N, Hibi K, Kosuge M, Tamura K, Kimura K. Impact of red blood cell distribution width and mean platelet volume in patients with ST-segment elevation myocardial infarction. Heart Vessels 2021; 37:392-399. [PMID: 34518907 DOI: 10.1007/s00380-021-01936-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 09/03/2021] [Indexed: 12/12/2022]
Abstract
The complete blood cell count is one of the most frequently ordered laboratory tests, and many parameters, including red blood cell distribution width (RDW) and mean platelet volume (MPV), are available. The purpose of this study was to investigate the usefulness of the combination of RDW and MPV in patients with ST-segment elevation myocardial infarction (STEMI). Patients with STEMI who underwent primary percutaneous coronary intervention were retrospectively enrolled (n = 229). The association between RDW as well as MPV and cardiovascular events was investigated. The median age was 67 years, and males made up 85% of the sample. Median RDW was 13.6%, and median MPV was 8.2 fL. During a median follow-up period of 528 days (IQR 331.5-920.5), 41 patients died or experienced major adverse cardiac and cerebrovascular events (MACCEs). Patients with RDW ≧ 13.7% had more deaths or MACCEs with marginal significance (p = 0.0799). Patients with MPV ≧ 8.3 fL had significantly more deaths or MACCEs (p = 0.0283). Patients with RDW ≧ 13.7% and MPV ≧ 8.3 fL had significantly more deaths or MACCEs (p = 0.0185). MPV was significantly associated with death or adverse events in patients with STEMI who were treated with primary PCI. RDW had only a weak association with death or adverse events. The results of the combination of MPV and RDW were similar to those of MPV.
Collapse
Affiliation(s)
- Toshiaki Ebina
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Shiori Tochihara
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Mai Okazaki
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Kazuyo Koike
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Yuko Tsuto
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Megumi Tayama
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Yukiko Takanami
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Haruka Hirose
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Mutsuo Horii
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.,Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kozo Okada
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yasushi Matsuzawa
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Nobuhiko Maejima
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Noriaki Iwahashi
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kiyoshi Hibi
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Masami Kosuge
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kazuo Kimura
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| |
Collapse
|
9
|
Vakili H, Khaheshi I, Sharifi A, Nickdoost N, Namazi MH, Safi M, Saadat H, Parsa SA, Akbarzadeh MA, Naderian M, Yousefi N, Shirazi M, Tabary M. Assessment of Admission Time Cell Blood Count (CBC) Parameters in Predicting Post-primary Percutaneous Coronary Intervention TIMI Frame Count in Patients with ST-segment Elevation Myocardial Infarction. Cardiovasc Hematol Disord Drug Targets 2021; 20:191-197. [PMID: 32026789 DOI: 10.2174/1871529x20666200206123118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 01/07/2020] [Accepted: 01/13/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVES In this study, we aimed to assess the value of admission time CBC parameters in predicting post-primary PCI corrected TIMI frame count. BACKGROUND Recent years have witnessed a large series of studies evaluating different laboratory variables to predict no-reflow phenomenon following primary PCI (PPCI) in patients with STEMI. However, a general agreement about the most reliable predictor of the no-reflow phenomenon is challenging and also intriguing. METHODS The current study concluded 208 consecutive patients who underwent primary PCI for ST-Elevation Myocardial Infarction (STEMI) from January 2014 to February 2016. Blood samples were obtained after taking ECG. Complete blood samples were collected and analyzed within 5 minutes from sampling. Post-PCI corrected Thrombolysis in Myocardial Infarction (TIMI) frame count was determined by one interventional cardiologist blinded to patients' clinical data. The correlation between admission time blood parameters and post-primary PCI corrected TIMI frame count in patients with STEMI were assessed. RESULTS Corrected TIMI frame count was positively correlated with WBC count (R: 0.18, P-value: <0.01), neutrophil count (R: 0.34, P-value: <0.01), and platelet count (R: 0.23, P-value: <0.01) and negatively correlated with lymphocyte count (R: -0.2, P-value: <0.01). Multiple linear regression results demonstrated that corrected TIMI frame count was positively correlated with neutrophil count (P < 0·001) and platelet count (P < 0·001) and negatively correlated with lymphocyte count (p=0.004). CONCLUSION High counts of WBC, neutrophil, and platelet and low count of lymphocyte may be predictors of no-reflow in STEMI patients undergoing PPCI. The clinical significance of such predictive parameters becomes clear as we consider the treatment approach in STEMI patients. Appropriate risk stratification leads to better treatment planning and allocation of resources.
Collapse
Affiliation(s)
- Hossein Vakili
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Isa Khaheshi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirsina Sharifi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Nickdoost
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad H Namazi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Safi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Habibollah Saadat
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed A Parsa
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad A Akbarzadeh
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Naderian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Yousefi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahin Shirazi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
10
|
Dai C, Chen Z, Qian J, Ge J. Red Cell Distribution Width as a Marker of Periprocedural Myocardial Infarction in Patients with Elective Percutaneous Coronary Intervention. J Cardiovasc Transl Res 2020; 14:449-456. [PMID: 33029742 DOI: 10.1007/s12265-020-10073-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 09/15/2020] [Indexed: 11/25/2022]
Abstract
We aimed to investigate whether red cell distribution width (RDW) was associated with periprocedural myocardial infarction (PMI) in patients undergoing elective percutaneous coronary intervention (PCI). Among 1723 consecutive patients undergoing elective PCI, a total of 230 (13.3%) met the diagnostic criteria of PMI. The high RDW (≥ 12.6%) group tended to have PMI (15.4% vs. 11.2%, P = 0.010). RDW was an independent predictor of PMI whether as a categorical variable (adjusted odds ratio = 1.442, 95% confidence interval = 1.088 to 1.911, P = 0.011) or a continuous variable (adjusted odds ratio = 1.236, 95% confidence interval = 1.079 to 1.415, P = 0.002). High RDW was also significantly associated with increased risk of major adverse cardiovascular events (MACE) during follow-up. However, anemia was not independently associated with PMI or MACE in the current study. In conclusion, RDW showed strong and independent association with PMI in patients undergoing elective PCI.
Collapse
Affiliation(s)
- Chunfeng Dai
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Zhangwei Chen
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Juying Qian
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
| | - Junbo Ge
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| |
Collapse
|
11
|
ÖZMEN FN, SULTANOĞLU H, ÇAVUŞ U, ÖZTÜRK A. Diagnostic Comparison Of Troponin and Scube 1 Levels In Patients Diagnosed with Stemi and Nstemi In The Emergency Department. KONURALP TIP DERGISI 2020. [DOI: 10.18521/ktd.759490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
12
|
Bao D, Luo G, Kan F, Wang X, Luo J, Jiang C. Prognostic value of red cell distribution width in patients undergoing percutaneous coronary intervention: a meta-analysis. BMJ Open 2020; 10:e033378. [PMID: 32912972 PMCID: PMC7485231 DOI: 10.1136/bmjopen-2019-033378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To evaluate the prognostic value of baseline red cell distribution width (RDW) in patients with coronary artery diseases (CADs) undergoing percutaneous coronary intervention (PCI) by conducting a meta-analysis. DESIGN Systematic review and meta-analysis. DATA SOURCE PubMed, Embase, Wanfang, CNKI and VIP databases were searched from their inceptions to 19 June 2019. ELIGIBLE CRITERIA Studies investigating the value of baseline RDW for predicting all-cause mortality, cardiovascular mortality and major adverse cardiac events (MACEs) in patients with CAD undergoing PCI were included. DATA EXTRACTION AND SYNTHESIS Two authors independently extracted the data and evaluated the methodological quality using the Newcastle-Ottawa Scale. STATA V.12.0 software was applied to produce the forest plots using a random-effect model. RESULTS Twelve studies (13 articles) involving 17 113 patients were included and analysed. Comparison between the highest and lowest RDW category indicated that the pooled risk ratio (RR) was 1.77 (95% CI 1.32 to 2.37) for all-cause mortality, 1.70 (95% CI 1.25 to 2.32) for cardiovascular mortality and 1.62 (95% CI 1.21 to 2.18) for MACEs. The predictive effect of elevated RDW for all-cause mortality was stronger in the subgroup of patients without anaemia (RR 4.59; 95% CI 3.07 to 6.86) than with anaemia. CONCLUSIONS This meta-analysis indicated that elevated RDW was associated with higher risk of mortality and adverse cardiac events in patients with CAD undergoing PCI. The value of elevated RDW for predicting all-cause mortality appears to be stronger in patients without anaemia. RDW may be served as a promising prognostic biomarker in patients undergoing PCI.
Collapse
Affiliation(s)
- Donglai Bao
- Department of Cardiovascular disease, Yiwu Central Hospital, Yiwu, China
| | - Gaojiang Luo
- Department of Cardiovascular disease, Yiwu Central Hospital, Yiwu, China
| | - Fuqiang Kan
- Department of Cardiovascular disease, Yiwu Central Hospital, Yiwu, China
| | - Xiaoyan Wang
- Department of Cardiovascular disease, Yiwu Central Hospital, Yiwu, China
| | - Jinwei Luo
- Department of Cardiovascular disease, Yiwu Central Hospital, Yiwu, China
| | - Changhao Jiang
- Department of Cardiovascular disease, Yiwu Central Hospital, Yiwu, China
| |
Collapse
|
13
|
Zhang E, Gao M, Gao J, Xiao J, Li X, Zhao H, Wang J, Zhang N, Wang S, Liu Y. Inflammatory and Hematological Indices as Simple, Practical Severity Predictors of Microdysfunction Following Coronary Intervention: A Systematic Review and Meta-Analysis. Angiology 2020; 71:349-359. [PMID: 32013536 DOI: 10.1177/0003319719896472] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
C-reactive protein (CRP) and high-sensitivity CRP (hsCRP), along with a series of hematological indices, platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), mean platelet volume (MPV), platelet distribution width (PDW), and red blood cell distribution width (RDW), are regarded to be related to the incidence of no-reflow or slow flow. Clinical studies were retrieved from the electronic databases of PubMed, EMBASE, Google Scholar, Clinical Trials, and science direct from their inception to August 24, 2019. A total of 21 studies involving 7403 patients were included in the meta-analysis. Pooled analysis results revealed patients with higher hsCRP (odds ratio [OR] = 1.03, 95% confidence interval [CI], 1.01-1.05, P = .006), hsCRP (OR = 1.04, 95% CI: 1.0-1.08, P = .012), NLR (OR = 1.23, 95% CI: 1.11-1.37, P < .0001), PLR (OR = 1.13, 95% CI: 1.07-1.20, P < .0001), and MPV (OR = 2.13, 95% CI: 1.57-2.90, P < .0001) all exhibited significantly higher no-reflow incidence, but there was no significant association between no-reflow risk and RDW or PDW. Patients with higher CRP/hsCRP also performed higher rate of slow flow (OR = 1.06, 95% CI: 1.01-1.11, P = .018). Preangiographic CRP/hsCRP could independently predict no-reflow and slow flow. Moreover, some hematological indices are associated with no-flow.
Collapse
Affiliation(s)
- Enyuan Zhang
- Department of Coronary Care Unit, Tianjin Chest Hospital, Tianjin, China
| | - Mingdong Gao
- Department of Coronary Care Unit, Tianjin Chest Hospital, Tianjin, China
| | - Jing Gao
- Institute of Cardiovascular Diseases, Tianjin Chest Hospital, Tianjin, China
| | - Jianyong Xiao
- Department of Coronary Care Unit, Tianjin Chest Hospital, Tianjin, China
| | - Xiaowei Li
- Department of Coronary Care Unit, Tianjin Chest Hospital, Tianjin, China
| | - Haiwang Zhao
- Department of Coronary Care Unit, Tianjin Chest Hospital, Tianjin, China
| | - Jixiang Wang
- Department of Coronary Care Unit, Tianjin Chest Hospital, Tianjin, China
| | - Nan Zhang
- Department of Coronary Care Unit, Tianjin Chest Hospital, Tianjin, China
| | - Shufeng Wang
- Department of Coronary Care Unit, Tianjin Chest Hospital, Tianjin, China
| | - Yin Liu
- Department of Coronary Care Unit, Tianjin Chest Hospital, Tianjin, China
| |
Collapse
|
14
|
Kocabaş H, Öncel CR, küçük M, Belgi Yıldırım A, kaçar C. Ankilozan Spondilit Hastalarında Kırmızı Hücre Dağılım Genişliği Ve Subklinik Sol Ventrikül Disfonksiyonu. ACTA MEDICA ALANYA 2018. [DOI: 10.30565/medalanya.393936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
15
|
Abrahan LL, Ramos JDA, Cunanan EL, Tiongson MDA, Punzalan FER. Red Cell Distribution Width and Mortality in Patients With Acute Coronary Syndrome: A Meta-Analysis on Prognosis. Cardiol Res 2018; 9:144-152. [PMID: 29904449 PMCID: PMC5997444 DOI: 10.14740/cr732w] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 05/22/2018] [Indexed: 12/11/2022] Open
Abstract
Background Red cell distribution width (RDW), a routine component of the complete blood count (CBC), measures variation in the size of circulating erythrocytes. It has been associated with several clinical outcomes in cardiovascular disease. We sought to strengthen the association between RDW and mortality in patients admitted for acute coronary syndrome (ACS) by pooling together data from available studies. Methods Studies that fulfilled the following were identified for analysis: 1) observational; 2) included patients admitted for ACS; 3) reported data on all-cause or cardiovascular (CV) mortality in association with a low or high RDW; and 4) used logistic regression analysis to control for confounders. Using MEDLINE, Clinical Key, ScienceDirect, Scopus, and Cochrane Central Register of Controlled Trials databases, a search for eligible studies was conducted until January 9, 2017. The quality of each study was evaluated using the Newcastle-Ottawa Quality Assessment Scale. Our primary outcome of interest was all-cause or CV mortality. We also investigated the impact of RDW on major adverse cardiovascular events (MACEs) for the studies that reported these outcomes. Review Manager (RevMan) 5.3 was utilized to perform Mantel-Haenzel analysis of random effects and compute for relative risk. Results We identified 13 trials involving 10,410 patients, showing that in ACS, a low RDW is associated with a statistically significant lower all-cause or CV mortality (RR 0.35, (95% CI 0.30 to 0.40), P < 0.00001, I2 = 53%), a finding that was consistent both in the short- and long-term. Conclusions A low RDW is also associated with lower risk for MACEs after an ACS (RR 0.56, (95% CI 0.51 to 0.61), P < 0.00001, I2 = 91%). A low RDW during an ACS is associated with lower all-cause or CV mortality and lower risk of subsequent MACEs, providing us with a convenient and inexpensive risk stratification tool in ACS patients.
Collapse
Affiliation(s)
- Lauro L Abrahan
- Section of Cardiology, University of the Philippines, Philippine General Hospital, Manila Philippines 1000, Philippines
| | - John Daniel A Ramos
- Section of Cardiology, University of the Philippines, Philippine General Hospital, Manila Philippines 1000, Philippines
| | - Elleen L Cunanan
- Section of Cardiology, University of the Philippines, Philippine General Hospital, Manila Philippines 1000, Philippines
| | - Marc Denver A Tiongson
- Section of Cardiology, University of the Philippines, Philippine General Hospital, Manila Philippines 1000, Philippines
| | - Felix Eduardo R Punzalan
- Section of Cardiology, University of the Philippines, Philippine General Hospital, Manila Philippines 1000, Philippines
| |
Collapse
|
16
|
Budzianowski J, Pieszko K, Burchardt P, Rzeźniczak J, Hiczkiewicz J. The Role of Hematological Indices in Patients with Acute Coronary Syndrome. DISEASE MARKERS 2017; 2017:3041565. [PMID: 29109595 PMCID: PMC5646322 DOI: 10.1155/2017/3041565] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 08/21/2017] [Indexed: 02/08/2023]
Abstract
An increased systemic and local inflammation plays a key role in the pathophysiology of acute coronary syndrome (ACS). This review will discuss the role of hematological indices: white blood cells (WBC), neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), and platelet indices, that is, platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet distribution width (PDW) in the case of ACS. In recent years, a strong interest has been drawn to these indices, given that they may provide independent information on pathophysiology, risk stratification, and optimal management. Their low-cost and consequent wide and easy availability in daily clinical practice have made them very popular in the laboratory testing. Furthermore, many studies have pointed at their effective prognostic value in all-cause mortality, major cardiovascular events, stent thrombosis, arrhythmias, and myocardial perfusion disorders in terms of acute myocardial infarction and unstable angina. The most recent research also emphasizes their significant value in the combined analysis with other markers, such as troponin, or with GRACE, SYNTAX, and TIMI scores, which improve risk stratification and diagnosis in ACS patients.
Collapse
Affiliation(s)
| | - Konrad Pieszko
- Department of Cardiology, Hospital Nowa Sól, Nowa Sól, Poland
| | - Paweł Burchardt
- Department of Biology and Environmental Sciences, Poznań University of Medical Sciences, Poznań, Poland
- Department of Cardiology, J. Struś Hospital, Poznań, Poland
| | | | | |
Collapse
|
17
|
Celik T, Balta S, Mikhailidis DP, Ozturk C, Aydin I, Tok D, Yildirim AO, Demir M, Iyisoy A. The Relation Between No-Reflow Phenomenon and Complete Blood Count Parameters. Angiology 2016; 68:381-388. [PMID: 27418628 DOI: 10.1177/0003319716659193] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The no-reflow (NR) phenomenon represents an acute reduction in coronary blood flow without coronary vessel obstruction, coronary vessel dissection, spasm, or thrombosis. No reflow is an important complication among patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). The complete blood count (CBC) is one of the most frequently ordered laboratory tests in clinical practice. Various studies have evaluated the performance of CBC parameters to predict disease severity and mortality risk. Automated cell counters are routinely available in many clinical laboratories and can be used to determine red blood cell distrubiton width (RDW), platetecrit, platelet count, and and some ratios like the neutrophil-lymphocyte ratio and RDW-platelet ratio. These hematological markers have been reported to be independent predictors of impaired angiographic reperfusion and long-term mortality among patients with STEMI undergoing pPCI. In this context, we reviewed the role of admission CBC parameters for the prediction of NR in patients with STEMI undergoing pPCI.
Collapse
Affiliation(s)
- Turgay Celik
- 1 Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Ankara, Turkey
| | - Sevket Balta
- 1 Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Ankara, Turkey
| | - Dimitri P Mikhailidis
- 2 Department of Clinical Biochemistry, University College London Medical School, University College London, London, England
| | - Cengiz Ozturk
- 1 Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Ankara, Turkey
| | - Ibrahim Aydin
- 3 Department of Clinical Biochemistry, School of Medicine, Gulhane Military Medical Academy, Ankara, Turkey
| | - Duran Tok
- 4 Department of Infectious Diseases, Gulhane Military Medical Academy, School of Medicine, Ankara, Turkey
| | - Ali Osman Yildirim
- 1 Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Ankara, Turkey
| | - Mustafa Demir
- 1 Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Ankara, Turkey
| | - Atila Iyisoy
- 1 Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Ankara, Turkey
| |
Collapse
|
18
|
Karakas MS, Korucuk N, Tosun V, Altekin RE, Koç F, Ozbek SC, Ozel D, Ermis C. Red cell distribution width and neutrophil-to-lymphocyte ratio predict left ventricular dysfunction in acute anterior ST-segment elevation myocardial infarction. J Saudi Heart Assoc 2016; 28:152-8. [PMID: 27358532 PMCID: PMC4917641 DOI: 10.1016/j.jsha.2015.07.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 07/06/2015] [Accepted: 07/06/2015] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES Red cell distribution width (RDW) and neutrophil-to-lymphocyte ratio (NLR) are the two markers used to determine risk of mortality and adverse cardiovascular outcomes in patients with acute myocardial infarction. The relationship between RDW, NLR, and left ventricular (LV) systolic functions has not been reported. In this report, we aimed to investigate the relationship between RDW, NLR, and LV systolic function in anterior ST-segment elevation myocardial infarction (STEMI) patients who underwent primary percutaneous coronary intervention (PCI). METHODS RDW and NLR were measured on admission in 106 STEMI patients treated with primary PCI. Patients were divided into two groups according to left ventricular ejection fraction (LVEF), as Group I (systolic dysfunction, LVEF <50%) and Group II (preserved global left ventricle systolic function, LVEF ⩾50%). The first group included 47 patients and the second group included 59 patients. RESULTS Mean RDW and NLR were significantly higher in Group I compared to Group II [13.7 ± 0.9% vs. 13.4 ± 0.7%, p = 0.03 and 5.86 (range, 0.66-40.50) vs. 2.75 (range, 0.51-39.39), p = 0.013, respectively]. CONCLUSION Increased RDW and NLR on admission, in anterior STEMI patients treated with primary PCI are associated with LV systolic dysfunction.
Collapse
Affiliation(s)
- Mustafa Serkan Karakas
- Department of Cardiology, Akdeniz University Medical Faculty, Dumlupinar Bouleward, Konyaaltı, Antalya, Turkey
| | - Necmettin Korucuk
- Department of Cardiology, Akdeniz University Medical Faculty, Dumlupinar Bouleward, Konyaaltı, Antalya, Turkey
| | - Veysel Tosun
- Department of Cardiology, Akdeniz University Medical Faculty, Dumlupinar Bouleward, Konyaaltı, Antalya, Turkey
| | - Refik Emre Altekin
- Department of Cardiology, Akdeniz University Medical Faculty, Dumlupinar Bouleward, Konyaaltı, Antalya, Turkey
| | - Fatih Koç
- Department of Cardiology, Akdeniz University Medical Faculty, Dumlupinar Bouleward, Konyaaltı, Antalya, Turkey
| | - Sinan Cemgil Ozbek
- Department of Cardiology, Ahi Evran University Education and Research Hospital, Kırşehir, Turkey
| | - Deniz Ozel
- Department of Biostatistics and Medical Informatics, Akdeniz University Medical Faculty, Dumlupinar Bouleward, Konyaaltı, Antalya, Turkey
| | - Cengiz Ermis
- Department of Cardiology, Akdeniz University Medical Faculty, Dumlupinar Bouleward, Konyaaltı, Antalya, Turkey
| |
Collapse
|
19
|
Bozorgi A, Khaki S, Mortazavi SH, Sadeghian S, Khoshnevis M, Tofighi S, Khaki A. Effect of Baseline Red Blood Cell Distribution Width on Short- and Intermediate-term Mortality of Patients Under Primary Percutaneous Coronary Intervention: A Survival Analysis. Crit Pathw Cardiol 2016; 15:69-74. [PMID: 27183257 DOI: 10.1097/hpc.0000000000000063] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Considering the limited studies specifically evaluating the role of Red blood cell distribution width (RDW) in primary percutaneous coronary intervention (PCI), we aimed to investigate the role of baseline RDW in short- and intermediate-term cardiovascular events in ST-elevation myocardial infarction patients under primary PCI. METHODS This is a historical cohort registry analysis of 1161 patients with ST-elevation myocardial infarction under primary PCI. According to inclusion criteria, 838 patients were allocated for analysis. Patients with RDW levels of 13.6% or higher were considered as high RDW group (third tertile). All the individuals were followed up for in-hospital and 6-month mortality along with readmission and composite major adverse cardiac events. RESULTS In-hospital deaths occurred in 53 (6.3%) patients and at 6-month follow-up 79 (9.4%) cases of mortality were documented. In-hospital and 6-month mortalities showed a significant trend in favor of high RDW group (13.3% vs. 5.9%, P = 0.003; 19.7% vs. 7.9%, P < 0.001, respectively). Multivariate analysis showed that high RDW was significantly and independently associated with higher rates of 6-month mortality (hazard ratio: 2.909; 95% confidence interval: 1.166-7.257; P = 0.022). RDW was also a significant predictor for 6-month mortality independent of anemia (hazard ratio: 2.811; 95% confidence interval: 1.047-7.551; P = 0.040). CONCLUSIONS We found a significant association between high RDW and in-hospital and 6-month mortality as well as the occurrence of major adverse cardiac event. Meanwhile RDW was found to be a significant predictor for 6-month mortality independent of anemia. Thus, it would be beneficial to use RDW as a risk stratification index to identify high risk intent-to-treat patients.
Collapse
Affiliation(s)
- Ali Bozorgi
- From the *Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran; and †School of medicine, Hamedan University of Medical Sciences, Hamedan, Iran
| | | | | | | | | | | | | |
Collapse
|
20
|
Gurbuz O, Kumtepe G, Ozkan H, Karal IH, Ercan A, Ener S. Red blood cell distribution width predicts long term cardiovascular event after on-pump beating coronary artery bypass grafting. J Cardiothorac Surg 2016; 11:48. [PMID: 27059704 PMCID: PMC4826544 DOI: 10.1186/s13019-016-0465-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 04/05/2016] [Indexed: 01/19/2023] Open
Abstract
Background Reports investigating the predictive value of red cell distribution width (RDW) on major cardiac and cardiovascular event (MACCE) following coronary artery bypass grafting (CABG) have major limitations, including lack of elimination of common factors affecting RDW levels, such as anemia. The purpose of this study is to identify the real effect of higher RDW level, free from the other factors, on MACCE following CABG. Methods Data of 500 consecutive, non-anemic patients (77.2 % male and mean age 63.05 ± 9.24) undergoing ONBHCAB between January 2007 and January 2010, were analyzed retrospectively. Results Overall MACCE was 7.8 % of all cases. Mean follow-up was 66.5 ± 9.96 months. In multivariate Cox regression analysis, RDW (P = 0.022) remained the only independent predictor of MACCE and the ROC analyze revealed an RDW cut-off value of 13.95 % predicting MACCE. Therefore, patients were grouped on this cut-off value. There were 238 patients in the lower RDW group (Group 1) and 262 patients in the higher RDW group (Group 2). Kaplan–Meier survival analysis of freedom from MACCE revealed significantly lower event free survival in Group 2 (P < 0.001 by the log-rank test). Group 2 showed a higher MACCE incidence in 1 year (P = 0.030), in 3 years (P < 0.001) and in 6 years (P < 0.001). The long-term follow-up was similar regarding noncardiovascular mortality. Conclusion An RDW level greater than 13.95 % in hospital admission is independently associated with an increased incidence of MACCE after CABG. Physicians should be more aggressive in the management of these patients.
Collapse
Affiliation(s)
- Orcun Gurbuz
- Department of Cardiovascular Surgery, Balikesir University, School of Medicine, 10010, Balikesir, Turkey.
| | - Gencehan Kumtepe
- Department of Cardiovascular Surgery, Balikesir University, School of Medicine, 10010, Balikesir, Turkey
| | - Hakan Ozkan
- Department Of Cardiology, Bahcesehir University Faculty of Medicine, Istanbul, Turkey
| | - Ilker Hasan Karal
- Department of Cardiovascular Surgery, Samsun Hospital for Education and Research, Ilkadim, 55090, Samsun, Turkey
| | - Abdulkadir Ercan
- Department of Cardiovascular Surgery, Balikesir University, School of Medicine, 10010, Balikesir, Turkey
| | - Serdar Ener
- Department of Cardiovascular Surgery, Acıbadem Bursa Hospital, Bursa, Turkey
| |
Collapse
|
21
|
Red cell distribution width is a predictor of ST resolution and clinical outcome following thrombolysis in acute ST elevation myocardial infarction. Thromb Res 2016; 140:1-6. [PMID: 26896606 DOI: 10.1016/j.thromres.2016.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 02/01/2016] [Accepted: 02/07/2016] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Red cell distribution width (RDW) has been shown to associate with adverse outcomes in various cardiovascular diseases. We aimed to explore the predictive value of RDW for resolution of the ST segment (STR) after thrombolytic therapy in patients with ST elevation myocardial infarction (STEMI). METHODS Patients with STEMI with indication for thrombolytic therapy were recruited from a university center between 2013 and 2015. A comprehensive laboratory investigation at the time of admission included measurement of RDW. Following thrombolysis ST segment resolution was assessed after 90 min. A positive response (STR ≥ 50%) was the primary endpoint. Secondary endpoints were major adverse cardiac events (MACE) defined as occurrence of acute heart failure, ventricular dysrhythmia beyond the first 24h, cardiac arrest or death during hospitalization. RESULTS A total of 312 patients (271 male) with the mean age of 57.9 ± 12.3 were enrolled. RDW on admission was 14.1 ± 1.0% (range: 11.6-17.7%). STR was seen in 191 cases (61.2%). MACE occurred in 36 (11.5%) patients. The long-term mortality rate was 7.1% during the follow-up period of 7.7 ± 3.2 months. Even after adjusting for co-morbid conditions, in multivariate model, baseline RDW, independently predicts STR (RR=2.46, 95% CI 1.32-4.57, P=0.005) and in hospital occurrence of MACE (RR=3.17, 95% CI 1.23-8.46, p=0.017). The cut-off values for RDW in predicting STR and MACE were 14.2% and 14.4%, respectively. CONCLUSION An elevated baseline RDW could predict adverse outcomes and response to thrombolytic therapy in patients with STEMI. This extends our knowledge about RDW value in prognostication.
Collapse
|
22
|
|
23
|
Akboga MK, Yayla C, Yilmaz S, Sen F, Balci KG, Ozcan F, Aras D. Increased red cell distribution width predicts occlusion of the infarct-related artery in STEMI. SCAND CARDIOVASC J 2015; 50:114-8. [PMID: 26651498 DOI: 10.3109/14017431.2015.1119303] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Infarct-related artery (IRA) patency yields a better outcome in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Red cell distribution width (RDW) emerges as a marker of adverse cardiovascular events and mortality in STEMI. Therefore, we aimed to assess the relationship between IRA patency and RDW value on admission in patients with STEMI undergoing primary PCI. METHODS A total of 564 patients with STEMI undergoing primary PCI were recruited in this study. According to thrombolysis in myocardial infarction (TIMI) flow grade in the IRA before PCI, the study population was divided into two groups as TIMI 0 or 1 group (occluded IRA, n = 398) and TIMI 2 or 3 group (patent IRA, n = 166). RESULTS RDW was significantly higher in the occluded IRA group (15.1 ± 1.7 versus 13.4 ± 1.3, p < 0.001) as compared to the patent IRA group. White blood cell (WBC) count, platelet count, creatine kinase-myocardial band (CK-MB) and troponin-I levels were also significantly higher in the occluded IRA group (p < 0.05). Moreover, RDW showed positive correlations with troponin-I (r = 0.397, p < 0.001), CK-MB (r = 0.344, p < 0.001) and WBC (r = 0.219, p < 0.001). In multivariate regression analysis, RDW (OR: 0.483, 95% CI: 0.412-0.567, p < 0.001) and WBC count were significantly and independently associated with IRA patency. CONCLUSIONS Our findings suggested that RDW value and WBC count on admission were independent predictors of IRA patency in patients with STEMI. As RDW is an easily available, simple and cheap biomarker, it can be used in daily practice as a novel predictor for IRA patency.
Collapse
Affiliation(s)
- Mehmet Kadri Akboga
- a Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic , Ankara , Turkey
| | - Cagri Yayla
- a Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic , Ankara , Turkey
| | - Samet Yilmaz
- a Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic , Ankara , Turkey
| | - Fatih Sen
- a Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic , Ankara , Turkey
| | - Kevser Gulcihan Balci
- a Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic , Ankara , Turkey
| | - Firat Ozcan
- a Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic , Ankara , Turkey
| | - Dursun Aras
- a Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic , Ankara , Turkey
| |
Collapse
|
24
|
The Prognostic Role of Red Blood Cell Distribution Width in Coronary Artery Disease: A Review of the Pathophysiology. DISEASE MARKERS 2015; 2015:824624. [PMID: 26379362 PMCID: PMC4563066 DOI: 10.1155/2015/824624] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 08/14/2015] [Accepted: 08/18/2015] [Indexed: 12/30/2022]
Abstract
Red blood cell distribution width (RDW) is a measure of red blood cell volume variations (anisocytosis) and is reported as part of a standard complete blood count. In recent years, numerous studies have noted the importance of RDW as a predictor of poor clinical outcomes in the settings of various diseases, including coronary artery disease (CAD). In this paper, we discuss the prognostic value of RDW in CAD and describe the pathophysiological connection between RDW and acute coronary syndrome. In our opinion, the negative prognostic effects of elevated RDW levels may be attributed to the adverse effects of independent risk factors such as inflammation, oxidative stress, and vitamin D3 and iron deficiency on bone marrow function (erythropoiesis). Elevated RDW values may reflect the intensity of these phenomena and their unfavorable impacts on bone marrow erythropoiesis. Furthermore, decreased red blood cell deformability among patients with higher RDW values impairs blood flow through the microcirculation, resulting in the diminution of oxygen supply at the tissue level, particularly among patients suffering from myocardial infarction treated with urgent revascularization.
Collapse
|
25
|
Clinical evaluation of red cell distribution width and contrast-induced acute kidney injury in percutaneous coronary interventions. Coron Artery Dis 2015; 26:283-5. [DOI: 10.1097/mca.0000000000000239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
26
|
Akboga MK, Canpolat U, Sahinarslan A, Alsancak Y, Nurkoc S, Aras D, Aydogdu S, Abaci A. Association of serum total bilirubin level with severity of coronary atherosclerosis is linked to systemic inflammation. Atherosclerosis 2015; 240:110-4. [PMID: 25770689 DOI: 10.1016/j.atherosclerosis.2015.02.051] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 01/20/2015] [Accepted: 02/23/2015] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Although cardiovascular protective action of bilirubin has been attributed to its antioxidant effect, there was scarce data regarding the anti-inflammatory properties. Herein, we aimed to assess the relationship between serum total bilirubin level and severity of coronary artery disease (CAD) in association with the direct inflammatory marker such as C-reactive protein (CRP), the other indirect markers included in inflammation process such as neutrophil to lymphocyte ratio (NLR) and red cell distribution width (RDW) in patients with stable CAD. METHODS Angiographic data of 1501 patients were analyzed in this retrospective cross-sectional study. Patients were categorized according to Gensini scores as control, mild CAD and severe CAD groups. The association of clinical and laboratory parameters with the severity of CAD were determined by multivariable linear regression analysis. RESULTS Total bilirubin level in the control group was significantly higher than those of the other groups. After multivariable linear regression analysis total bilirubin [β=-3.131 (-4.481, -1.782), p<0.001] was significantly associated with the severity of CAD. Futhermore, there was a moderate and significant inverse correlation between serum total bilirubin level and the severity of CAD (r=-0.173, p<0.001), CRP (r=-0.112, p<0.001), NLR (r=-0.070, p=0.026) and RDW (r=-0.074, p=0.027). CONCLUSION Serum total bilirubin level was independently and inversely associated with the severity of coronary atherosclerosis in patients with stable CAD. In addition, total bilirubin level was inversely correlated with CRP, NLR and RDW. These results suggest that besides its already known effect on the oxidative stress, higher serum total bilirubin level may exhibit an anti-inflammatory effect in the coronary atherosclerotic process.
Collapse
Affiliation(s)
- Mehmet Kadri Akboga
- Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
| | - Ugur Canpolat
- Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - Asife Sahinarslan
- Gazi University Medical Faculty, Department of Cardiology, Ankara, Turkey
| | - Yakup Alsancak
- Gazi University Medical Faculty, Department of Cardiology, Ankara, Turkey
| | - Serdar Nurkoc
- Gazi University Medical Faculty, Department of Cardiology, Ankara, Turkey
| | - Dursun Aras
- Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - Sinan Aydogdu
- Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - Adnan Abaci
- Gazi University Medical Faculty, Department of Cardiology, Ankara, Turkey
| |
Collapse
|
27
|
Isik T, Ayhan E, Kurt M, Tanboga IH, Kaya A, Aksakal E. Is red cell distribution width a marker for the presence and poor prognosis of cardiovascular disease? Eurasian J Med 2015; 44:169-71. [PMID: 25610234 DOI: 10.5152/eajm.2012.39] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Accepted: 08/29/2012] [Indexed: 11/22/2022] Open
Abstract
Red cell distribution width (RDW) is an indices heterogeneity of cell size in the peripheral blood and has been shown to be an independent correlate of adverse outcomes in healthy subjects and in some cardiac conditions. Additionally, RDW is associated with both the presence and the complexity of vascular disease. In this review we investigate the importance of RDW in vascular disease in the light of recent information.
Collapse
Affiliation(s)
- Turgay Isik
- Department of Cardiology, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Erkan Ayhan
- Department of Cardiology, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Mustafa Kurt
- Department of Cardiology, Erzurum Education and Research Hospital, Erzurum, Turkey
| | | | - Ahmet Kaya
- Department of Cardiology, Erzurum Education and Research Hospital, Erzurum, Turkey
| | - Enbiya Aksakal
- Department of Cardiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| |
Collapse
|
28
|
Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci 2014; 52:86-105. [PMID: 25535770 DOI: 10.3109/10408363.2014.992064] [Citation(s) in RCA: 592] [Impact Index Per Article: 59.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The red blood cell distribution width (RDW) is a simple and inexpensive parameter, which reflects the degree of heterogeneity of erythrocyte volume (conventionally known as anisocytosis), and is traditionally used in laboratory hematology for differential diagnosis of anemias. Nonetheless, recent evidence attests that anisocytosis is commonplace in human disorders such as cardiovascular disease, venous thromboembolism, cancer, diabetes, community-acquired pneumonia, chronic obstructive pulmonary disease, liver and kidney failure, as well as in other acute or chronic conditions. Despite some demographic and analytical issues related to the routine assessment that may impair its clinical usefulness, an increased RDW has a high negative predictive value for diagnosing a variety of disorders, but also conveys important information for short- and long-term prognosis. Even more importantly, the value of RDW is now being regarded as a strong and independent risk factor for death in the general population. Although it has not been definitely established whether an increased value of RDW is a risk factor or should only be considered an epiphenomenon of an underlying biological and metabolic imbalance, it seems reasonable to suggest that the assessment of this parameter should be broadened far beyond the differential diagnosis of anemias. An increased RDW mirrors a profound deregulation of erythrocyte homeostasis involving both impaired erythropoiesis and abnormal red blood cell survival, which may be attributed to a variety of underlying metabolic abnormalities such as shortening of telomere length, oxidative stress, inflammation, poor nutritional status, dyslipidemia, hypertension, erythrocyte fragmentation and alteration of erythropoietin function. As such, the aim of this article is to provide general information about RDW and its routine assessment, to review the most relevant implications in health and disease and give some insights about its potential clinical applications.
Collapse
Affiliation(s)
- Gian Luca Salvagno
- Clinical Chemistry Section, Department of Life and Reproductive Sciences, Academic Hospital of Verona , Verona , Italy
| | | | | | | |
Collapse
|
29
|
Su C, Liao LZ, Song Y, Xu ZW, Mei WY. The role of red blood cell distribution width in mortality and cardiovascular risk among patients with coronary artery diseases: a systematic review and meta-analysis. J Thorac Dis 2014; 6:1429-40. [PMID: 25364520 DOI: 10.3978/j.issn.2072-1439.2014.09.10] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 08/14/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND Red cell distribution width (RDW) might be a novel biomarker that reflects multiple physiological impairments related to atherosclerosis and coronary artery diseases (CAD). We conducted this systematic review and meta-analysis to evaluate the association of RDW between all-cause mortality and fatal/non-fatal cardiovascular disease (CVD) events in CAD patients. METHODS Relevant studies were searched and identified in the MEDLINE and EMBASE databases. English-language prospective studies that reported risk estimates for RDW and mortality/CVD events were included. Data were extracted regarding the characteristics and clinical outcomes, and a quality assessment was conducted. Results were extracted for the highest versus lowest RDW level, and meta-analyses were carried out using random effects models. RESULTS We identified 22 studies enrolling 80,216 participants. The study duration ranged between 1 month and 23 years. Of the 15 studies that were included in the meta-analysis, higher RDW indicated a significant increased risk for all-cause mortality in CAD patients: pooled risk ratio (RR) 2.20 (95% CI, 1.42-3.39; P<0.0004). The results for fatal, non-fatal and fatal/non-fatal events were: pooled RR 1.80 (95% CI, 1.35-2.41; P<0.0001), RR 1.86 (95% CI, 1.50-2.31; P<0.00001) and RR 2.13 (95% CI, 1.20-3.77; P=0.01). Heterogeneity was moderately present; however, sensitivity analyses for follow-up duration, CAD subtype, or RDW as dichotomous values showed similar results. CONCLUSIONS The meta-analysis indicates that higher RDW levels are associated with increased risk of mortality and CVD events in patients with established CAD.
Collapse
Affiliation(s)
- Chang Su
- 1 Department of Hematology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China ; 2 Department of Health, Guangdong Pharmaceutical University, Guangzhou Higher Education Mega Center, Guangzhou 510080, China ; 3 Department of Pathophysiology, ZhongShan Medical College, Sun Yat-sen University, Guangzhou 510080, China ; 4 Department of Cardiology, Huangpu Division of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| | - Li-Zhen Liao
- 1 Department of Hematology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China ; 2 Department of Health, Guangdong Pharmaceutical University, Guangzhou Higher Education Mega Center, Guangzhou 510080, China ; 3 Department of Pathophysiology, ZhongShan Medical College, Sun Yat-sen University, Guangzhou 510080, China ; 4 Department of Cardiology, Huangpu Division of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| | - Yan Song
- 1 Department of Hematology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China ; 2 Department of Health, Guangdong Pharmaceutical University, Guangzhou Higher Education Mega Center, Guangzhou 510080, China ; 3 Department of Pathophysiology, ZhongShan Medical College, Sun Yat-sen University, Guangzhou 510080, China ; 4 Department of Cardiology, Huangpu Division of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| | - Zhi-Wei Xu
- 1 Department of Hematology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China ; 2 Department of Health, Guangdong Pharmaceutical University, Guangzhou Higher Education Mega Center, Guangzhou 510080, China ; 3 Department of Pathophysiology, ZhongShan Medical College, Sun Yat-sen University, Guangzhou 510080, China ; 4 Department of Cardiology, Huangpu Division of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| | - Wei-Yi Mei
- 1 Department of Hematology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China ; 2 Department of Health, Guangdong Pharmaceutical University, Guangzhou Higher Education Mega Center, Guangzhou 510080, China ; 3 Department of Pathophysiology, ZhongShan Medical College, Sun Yat-sen University, Guangzhou 510080, China ; 4 Department of Cardiology, Huangpu Division of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| |
Collapse
|
30
|
Wang P, Wang Y, Li H, Wu Y, Chen H. Relationship between the red blood cell distribution width and risk of acute myocardial infarction. J Atheroscler Thromb 2014; 22:21-6. [PMID: 25186020 DOI: 10.5551/jat.23937] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS Recently, a number of studies have shown an increased red blood cell distribution width (RDW) to be a strong and independent predictor of the prognosis of coronary artery disease. The aim of this study was to investigate the underlying mechanisms responsible for the relationship between the RDW and a poor prognosis of coronary artery disease. METHODS Four hundred and twenty-four patients with ST elevation myocardial infarction treated with primary percutaneous coronary intervention (pPCI) were analyzed retrospectively. We evaluated the relationships between the RDW and the high-sensitivity C-reactive protein (hsCRP) N-terminal pro-brain natriuretic peptide (NTpro-BNP), fasting blood glucose and lipid levels, as well as other parameters of blood examinations and angiographic manifestations. RESULTS There were 85 patients in the RDW ≥ 14% group (mean age 60.62 ± 11.29 years, and men: 87%) and 339 patients in the RDW < 14% group (mean age: 59.74 ± 11.55 years, and men: 78%). The RDW ≥ 14% group had higher platelet distribution width (PDW), NTpro-BNP and hsCRP values on admission, a heavier intracoronary thrombotic burden and a higher incidence of three-branch vascular lesions than the RDW < 14% group. In the multiple logistic regression analysis, the associations between the RDW and the NTpro-BNP level, incidence of three-branch and left main lesions and intracoronary thrombotic burden remained. CONCLUSIONS A high RDW may be associated with the severity and instability of acute myocardial infarction.
Collapse
Affiliation(s)
- Ping Wang
- Department of heart center Capital Medical University Affiliated Beijing Friendship Hospital
| | | | | | | | | |
Collapse
|
31
|
Timóteo AT, Papoila AL, Lousinha A, Alves M, Miranda F, Ferreira ML, Ferreira RC. Predictive impact on medium-term mortality of hematological parameters in Acute Coronary Syndromes: added value on top of GRACE risk score. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2014; 4:172-9. [PMID: 25122727 DOI: 10.1177/2048872614547690] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Red Cell Distribution Width (RDW) prognostic value in patients with Acute Coronary Syndrome (ACS) has been well validated whereas that of Platelet Distribution Width (PDW) is less well known. OBJECTIVES Investigate the incremental prognostic value, on top of GRACE risk score, of a new variable resulting from the combination of RDW and PDW. METHODS Consecutive patients with ACS. Complete blood count, with RDW and PDW, was obtained. Primary endpoint was one-year all-cause mortality and Cox regression models were used to measure the influence of RDW and PDW on patients' survival time. A new combination categorical variable (RDW/PDW) was created with both discretized RDW and PDW and logistic regression models were used. Predictive value and discriminative ability of the model with GRACE risk score alone and of the model with inclusion of RDW/PDW was assessed. RESULTS We included 787 patients. Hospital and one-year mortality rates were 5.1% and 7.8%, respectively. Both continuous RDW and PDW were independent predictors of death. The best cut-off for RDW was 13.9%, and 14.5% for PDW. Inclusion of RDW/PDW in a model with GRACE risk score improved the AUC from 0.81 (95% CI 0.75-0.86) to 0.84 (95% CI 0.79-0.90) (p=0.024) with an improvement in total NRI (56%) and IDI (0.048). CONCLUSIONS Simple markers such as RDW and PDW can be useful in risk stratification of death after ACS. Combining both markers with GRACE risk score improved the predictive value for all-cause mortality and reduced the estimated risk of those who did not die.
Collapse
Affiliation(s)
- Ana T Timóteo
- Cardiology Department, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Portugal
| | - Ana L Papoila
- CEAUL, Biostatistics Department, Medical Sciences Faculty, New University of Lisbon, Portugal Epidemiology and Statistics Unit, Reserch Centre, Centro Hospitalar Lisboa Central, Portugal
| | - Ana Lousinha
- Cardiology Department, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Portugal
| | - Marta Alves
- Epidemiology and Statistics Unit, Reserch Centre, Centro Hospitalar Lisboa Central, Portugal
| | - Fernando Miranda
- Clinical Pathology Department, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Portugal
| | - Maria L Ferreira
- Cardiology Department, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Portugal
| | - Rui C Ferreira
- Cardiology Department, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Portugal
| |
Collapse
|
32
|
Red cell distribution width as a prognostic indicator in pediatric heart disease and after surgery. BIOMED RESEARCH INTERNATIONAL 2014; 2014:681679. [PMID: 24745021 PMCID: PMC3973010 DOI: 10.1155/2014/681679] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 02/11/2014] [Indexed: 11/18/2022]
Abstract
Background. Red cell distribution width (RDW) is an important marker which reflects inflammatory activity in many chronic diseases. The objective of this study is to investigate the impact of RDW on morbidity and mortality before and after pediatric congenital heart surgery. Methods. 107 patients with congenital heart disease, cardiac case group, and 70 patients, control group, without heart disease were retrospectively analyzed. Pre-, and postoperative and at discharge RDW of the cardiac patients were determined. Lengths of hospital and intensive care unit (ICU) stay and exited patients were determined. Results. Mean lengths of ICU and hospital stay were 3.3 ± 2.7 and 7.3 ± 2.9 days. In control group, mean preoperative RDW was 12.6 ± 1.4, while in cardiac case group it was significantly higher (15.1 ± 3.5). In cardiac case group, postoperative RDW were significantly higher than preoperative period, while RDW at discharge were significantly lower than postoperative estimates. A significant and a positive correlation was detected between lengths of ICU and hospital stay and RDW. RDW of the exited patients were significantly higher than the survivors. Conclusions. This study demonstrates that RDW can be used as an important indicator in the prediction of morbidity and mortality during pre-, and postoperative period of the pediatric congenital heart disease surgery.
Collapse
|
33
|
Abdullahi H, Osman A, Rayis DA, Gasim GI, Imam AM, Adam I. Red blood cell distribution width is not correlated with preeclampsia among pregnant Sudanese women. Diagn Pathol 2014; 9:29. [PMID: 24499498 PMCID: PMC3916796 DOI: 10.1186/1746-1596-9-29] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 12/18/2013] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Preeclampsia is a leading cause of maternal and perinatal mortality worldwide. The exact etiology of preeclampsia is unknown, but the inflammatory process is postulated as one of the etiologies. Red blood cell distribution width (RDW) is a measure of anisocytosis (variation of red cell size) and is associated with hypertension and diabetic ketoacidosis. There are few data on the association between RDW and preeclampsia. This study aimed to investigate the association between RDW and preeclampsia. METHODS A case-control study was conducted at Khartoum Hospital, Sudan, during June to August 2012. Cases were women with preeclampsia and healthy women were controls. Sociodemographic characteristics, obstetrics, and clinical data were recorded. The complete blood count, including RDW, was measured using an automated hematology analyzer. RESULTS The cases and controls (65 women in each arm) were matched in their basic characteristics. There was no difference in the mean (SD) RDW between women with preeclampsia and controls (14.5 ± 1.8% vs. 14.4 ± 1.4%, P = 0.710). There was also no difference in the mean RDW between women with mild and severe preeclampsia (14.7 ± 1.9% vs. 13.9 ± 1.4%, P = 0.144. In logistic regression, there was no association between RDW and preeclampsia (OR = 0.9, CI = 0.7-1.1, P = 0.952). CONCLUSIONS RDW levels are not associated with the presence or severity of preeclampsia. VIRTUAL SLIDES The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1206247718115175.
Collapse
Affiliation(s)
| | | | | | | | | | - Ishag Adam
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
| |
Collapse
|
34
|
Lyu T, Zhao Y, Zhang T, Zhou W, Yang F, He Q, Yuan A, Yao T, Pu J, He B. Effect of statin pretreatment on myocardial perfusion in patients undergoing primary percutaneous coronary intervention: a systematic review and meta-analysis. Clin Cardiol 2013; 36:E17-24. [PMID: 23893797 DOI: 10.1002/clc.22169] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 06/15/2013] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND To achieve sufficient myocardial perfusion in ST-segment elevation myocardial infarction (STEMI) patients receiving primary percutaneous coronary intervention (PPCI), many adjunctive therapies have been proposed. Previous trials have reported variances in myocardial perfusion improvement for statin pretreatment, which made it inconvincible to confirm the beneficial effects of statins. Therefore, we performed a systematic review and meta-analysis to determine whether statin pretreatment was effective in improving myocardial perfusion. HYPOTHESIS Statin pretreatment could improve myocardial perfusion in STEMI patients undergoing PPCI. METHODS We searched the PubMed, Web of Knowledge, and the Cochrane Library databases for studies evaluating the impact of statin pretreatment on myocardial perfusion in STEMI patients receiving PPCI. RESULTS Twelve trials were finally included in our meta-analysis. There were no significant differences in patients' baseline characteristics between the statin pretreatment and control groups. Overall pooled analysis showed that patients in the statin pretreatment groups had significantly better epicardial coronary blood flow (measured by Thrombosis in Myocardial Infarction [TIMI] grade, odds ratio [OR]: 0.49, 95% confidence interval [CI]: 0.28 to 0.84; measured by corrected TIMI frame count, mean difference: -5.63; 95% CI: -9.66 to -1.6). A trend toward myocardial tissue level perfusion improvement was seen in the statin pretreatment arm rather than the control arm (measured by myocardial blush grade, OR: 0.74; 95% CI: 0.50 to 1.09). CONCLUSIONS This present meta-analysis suggests that statin pretreatment might be effective in improving myocardial perfusion in STEMI patients.
Collapse
Affiliation(s)
- Ting Lyu
- Department of Cardiology, Shanghai Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Kaya A, Isik T, Kaya Y, Enginyurt O, Gunaydin ZY, Iscanli MD, Kurt M, Tanboga IH. Relationship between red cell distribution width and stroke in patients with stable chronic heart failure: a propensity score matching analysis. Clin Appl Thromb Hemost 2013; 21:160-5. [PMID: 23804231 DOI: 10.1177/1076029613493658] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
AIM We aimed to investigate the association between baseline red cell distribution width (RDW) level and the risk of stroke in patients with heart failure (HF). METHODS A total of 153 consecutive patients with HF (New York Heart Association [NYHA] I-III and left ventricular ejection fraction of <40%) were included in this prospective study. All the patients were followed up for 1 year, and during this period the cerebrovascular disease was questioned. RESULTS In matched population, using propensity score matching comparing patients with HF having stroke with patients without stroke, we found significantly increased basal RDW and serum uric acid. The receiver-operating characteristic curves of RDW for predicting stroke are performed. An RDW ≥ 15.2% measured on admission had 87% sensitivity and 74% specificity in predicting stroke in patients with HF (area under the curve: 0.923, 95% confidence interval: 0.852-0.994, P < .001). CONCLUSION In conclusion, this study demonstrated that RDW may be important hematological indices for stroke in patients with HF using propensity score analysis.
Collapse
Affiliation(s)
- Ahmet Kaya
- Department of Cardiology, Ordu University Medical School, Ordu, Turkey
| | - Turgay Isik
- Department of Cardiology, Erzurum Education and Research Hospital, Erzurum, Turkey
| | - Yasemin Kaya
- Department of Internal Medicine, Ordu University Medical School, Ordu, Turkey
| | - Ozgur Enginyurt
- Department of Family Medicine, Ordu University Medical School, Ordu, Turkey
| | | | - Murat Dogan Iscanli
- Department of Emergency Medicine, Ministry of Health-Ordu University Education and Research Hospital, Ordu, Turkey
| | - Mustafa Kurt
- Department of Cardiology, Erzurum Education and Research Hospital, Erzurum, Turkey
| | | |
Collapse
|
36
|
Luo SH, Jia YJ, Nie SP, Qing P, Guo YL, Liu J, Xu RX, Zhu CG, Wu NQ, Jiang LX, Dong Q, Liu G, Li JJ. Increased red cell distribution width in patients with slow coronary flow syndrome. Clinics (Sao Paulo) 2013; 68:732-7. [PMID: 23778485 PMCID: PMC3674286 DOI: 10.6061/clinics/2013(06)02] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 12/14/2012] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE An elevated red cell distribution width has been recognized as a predictor of various cardiovascular diseases. Slow coronary flow syndrome is an important angiographic clinical entity with an unknown etiology. This study aimed to examine the relationship between red cell distribution width and the presence of slow coronary flow syndrome. METHODS In total, 185 patients with slow coronary flow syndrome and 183 age- and gender-matched subjects with normal coronary flow (controls) were prospectively enrolled in this study. Red cell distribution width and C-reactive protein were measured upon admission, and the results were compared between the patients with slow coronary flow syndrome and normal controls. RESULTS Red cell distribution width levels were significantly higher in the patients with slow coronary flow syndrome than the normal controls. Moreover, the data showed that the plasma C-reactive protein levels were also higher in the patients with slow coronary flow syndrome than in the normal controls. In addition, a multivariate analysis indicated that C-reactive protein and red cell distribution width were the independent variables most strongly associated with slow coronary flow syndrome. Finally, the red cell distribution width was positively correlated with C-reactive protein and mean thrombosis in the myocardial infarction frame counts of the patients with slow coronary flow syndrome. CONCLUSION The data demonstrated that red cell distribution width levels are significantly higher and strongly positively correlated with both C-reactive protein and thrombosis in the myocardial infarction frame counts of patients with slow coronary flow syndrome. These findings suggest that red cell distribution width may be a useful marker for patients with slow coronary flow syndrome.
Collapse
Affiliation(s)
- Song-Hui Luo
- Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Division of Cardiology, State Key Laboratory of Cardiovascular Disease, Beijing/China
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Kurt RK, Aras Z, Silfeler DB, Kunt C, Islimye M, Kosar O. Relationship of red cell distribution width with the presence and severity of preeclampsia. Clin Appl Thromb Hemost 2013; 21:128-31. [PMID: 23728834 DOI: 10.1177/1076029613490827] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
AIM Although the relationship between red cell distribution width (RDW) and hypertension has been well documented, there is an absence of data on the association between RDW and preeclampsia. In the present study, we have aimed to investigate the correlation of RDW with preeclampsia and its severity. METHODS The study population consisted of 52 (35 mild and 17 severe) patients with preeclampsia and 50 control pregnancy patients. For the entire study population, baseline RDW was measured using an automatic blood counter. RESULTS Although there were no significant differences between the preeclampsia group and the control group in terms of hemoglobin and platelet counts, the RDW (14.1 ± 1.1 vs 16.9 ± 1.7, P < .001), systolic and diastolic blood pressure, proteinuria, white blood cell, and high-sensitivity C-reactive protein levels were significantly higher in the preeclampsia group. Moreover, subgroup analysis revealed that RDW levels were significantly increased in patients with severe preeclampsia when compared to the patients with mild preeclampsia (18 ± 1.5 vs 16.4 ± 1.5, P < .001). CONCLUSION Our study results revealed that RDW levels were associated with both the presence and the severity of preeclampsia.
Collapse
Affiliation(s)
- Raziye Keskin Kurt
- Department of Obstetrics and Gynecology, Antakya State Hospital of Obstetrics and Child Care, Hatay, Turkey
| | - Zinnur Aras
- Department of Obstetrics and Gynecology, Antakya State Hospital of Obstetrics and Child Care, Hatay, Turkey
| | - Dilek Benk Silfeler
- Department of Obstetrics and Gynecology, Mustafa Kemal University Medical School, Hatay, Turkey
| | - Cigdem Kunt
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Mine Islimye
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Ozlem Kosar
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| |
Collapse
|
38
|
Tanboga IH, Topcu S, Aksakal E, Kalkan K, Sevimli S, Acikel M. Determinants of angiographic thrombus burden in patients with ST-segment elevation myocardial infarction. Clin Appl Thromb Hemost 2013; 20:716-22. [PMID: 23539672 DOI: 10.1177/1076029613483169] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
AIMS We aimed to investigate the determinants of angiographic thrombus burden in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (pPCI). METHODS The study population consisted of 662 patients with nonanemic STEMI who underwent pPCI. Clinical, laboratory, and demographic properties of the patients were recorded. Baseline hematologic indices were measured at the time of admission. Angiographic coronary thrombus burden was scored based on thrombolysis in myocardial infarction (TIMI) thrombus grades. After wiring and/or small balloon dilation, patients with thrombus burden grades 4 and 5 were defined as high thrombus burden, and patients with thrombus burden <grade 4 was defined as low thrombus burden. RESULT Patients with high thrombus burden had more family history of coronary artery disease, longer pain to balloon time, higher Killip class (≥II), higher neutrophil to lymphocyte ratio, red cell distribution width (RDW), baseline creatine kinase-MB fraction (CK-MB) and baseline troponin, higher peak CK-MB, and peak troponinbut lower triglycerides. Angiographically, patients with high thrombus burden had longer lesion in the infarct-related artery, less frequent direct stenting, lower epicardial and myocardial perfusion, more frequent distal embolization, and more frequent electrocardiographic and angiographic no reflow. In multivariate logistic regression analysis, only RDW (odds ratio: 1.29, 95% confidence interval 1.19-1.39, P < .001) was determined as independent predictor. The area under the receiver-operating characteristic curve of the RDW was 0.733 (0.690-0.776, P < .001) to predict high TIMI thrombus burden. CONCLUSION Present study results demonstrated that high thrombus burden in patients with STEMI was associated with impaired postprocedural epicardial and myocardial perfusion and higher no reflow and distal embolization; and increased RDW values were independent predictors of coronary thrombus burden.
Collapse
Affiliation(s)
| | - Selim Topcu
- Department of Cardiology, Ataturk University Medical School, Erzurum, Turkey
| | - Enbiya Aksakal
- Department of Cardiology, Ataturk University Medical School, Erzurum, Turkey
| | - Kamuran Kalkan
- Department of Cardiology, Ataturk University Medical School, Erzurum, Turkey
| | - Serdar Sevimli
- Department of Cardiology, Ataturk University Medical School, Erzurum, Turkey
| | - Mahmut Acikel
- Department of Cardiology, Ataturk University Medical School, Erzurum, Turkey
| |
Collapse
|
39
|
Kurt M, Tanboga IH, Buyukkaya E, Karakas MF, Akçay AB, Sen N. Relation of red cell distribution width with CHA2DS2-VASc score in patients with nonvalvular atrial fibrillation. Clin Appl Thromb Hemost 2013; 20:687-92. [PMID: 23430929 DOI: 10.1177/1076029613478157] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Red cell distribution width (RDW) has been shown to be helpful in predicting adverse long-term events in patients with cardiovascular diseases. However, to date, no study has been conducted on the relationship between RDW and thromboembolism risk in atrial fibrillation (AF). Therefore, we aimed to investigate the relationship between RDW and CHA2DS2-VASc score used for the evaluation of thromboembolism risk in patients with AF. METHODS The study population consisted of 320 patients with AF. We calculated CHA2DS2-VASc risk score for each patient and baseline hemoglobin, white blood cell, RDW, mean platelet volume, platelet counts, estimated glomerular filtration rate (eGFR), left ventricular ejection fraction (LVEF), and left atrial volume index (LAVi) were measured. RESULTS High CHA2DS2-VASc score group had higher RDW, lower LVEF, higher LAVi, and lower eGFR values when compared to the low CHA2DS2-VASc score group. The multivariate logistic regression analysis performed to predict high CHA2DS2-VASc scores revealed that RDW eGFR, LVEF, and LAVi were independent predictors. The area under the receiver-operating characteristic curve of RDW was 0.65 (0.59-0.71, P < .001) to predict high CHA2DS2-VASc score. CONCLUSION Our study results indicate that RDW values are significantly correlated with CHA2DS2-VASc score in nonanemic patients with AF, while also being independent predictor of high CHA2DS2-VASc score.
Collapse
Affiliation(s)
- Mustafa Kurt
- Department of Cardiology, Mustafa Kemal University Medical School, Hatay, Turkey
| | | | - Eyup Buyukkaya
- Department of Cardiology, Mustafa Kemal University Medical School, Hatay, Turkey
| | - Mehmet Fatih Karakas
- Department of Cardiology, Mustafa Kemal University Medical School, Hatay, Turkey
| | - Adnan Burak Akçay
- Department of Cardiology, Mustafa Kemal University Medical School, Hatay, Turkey
| | - Nihat Sen
- Department of Cardiology, Mustafa Kemal University Medical School, Hatay, Turkey
| |
Collapse
|
40
|
Fabregat-Andrés Ó, Cubillos A, Estornell-Erill J, Fácila L, Morell S. The prognostic value of red cell distribution width in ST segment elevation myocardial infarction is independent of necrosis size. J Cardiovasc Med (Hagerstown) 2013; 18:560-562. [PMID: 23325344 DOI: 10.2459/jcm.0b013e32835dbcad] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Óscar Fabregat-Andrés
- aCardiology Department bCT and CMR Unit Eresa, Consorcio Hospital General Universitario de Valencia, Valencia. Spain
| | | | | | | | | |
Collapse
|
41
|
Tanboga IH, Topcu S, Nacar T, Aksakal E, Kalkan K, Kiki I, Sevimli S. Relation of coronary collateral circulation with red cell distribution width in patients with non-ST elevation myocardial infarction. Clin Appl Thromb Hemost 2012; 20:411-5. [PMID: 23262968 DOI: 10.1177/1076029612470490] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES We aimed to investigate the relationship between red cell distribution width (RDW) value and coronary collateral circulation (CCC) in patients with non-ST elevation myocardial infarction (NSTEMI). METHODS The study population consisted of 322 consecutive patients with NSTEMI. The patients were classified into impaired CCC (group 1, Rentrop grades 0-1) or good CCC (group 2, Rentrop grades 2-3). Baseline RDW was measured as part of the automated complete blood count. RESULTS The RDW values were significantly higher in patients with impaired CCC than in those with good CCC (17.2 ± 2.3 vs 14.5 ± 2.5, P < .001). In multivariate logistic regression analysis, RDW (odds ratio: 1.52, 95% confidence interval: 1.30-1.78, P < .001), baseline creatine kinase MB (CK-MB), and absence of preinfarction angina were found to be the independent predictors of impaired CCC. In receiver-operating characteristic curve analysis, the RDW value >15.5 yielded an area under curve value of 0.783, with 77% sensitivity and 73% specificity. CONCLUSIONS Our study results demonstrated that, high RDW, high CK-MB, and absence of preinfarction angina were found to be independent predictors of impaired CCC.
Collapse
Affiliation(s)
- Ibrahim Halil Tanboga
- 1Department of Cardiology, Heart Center, Ataturk University Medical School, Erzurum, Turkey
| | | | | | | | | | | | | |
Collapse
|
42
|
Isik T. Is red cell distribution width a marker for hypertension? Cardiology 2012; 123:195-6. [PMID: 23147470 DOI: 10.1159/000343679] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 09/24/2012] [Indexed: 11/19/2022]
|