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Liao Y, Zhang R, Shi S, Lin X, Wang Y, Wang Y, Chen W, Zhao Y, Bao K, Zhang K, Chen L, Fang Y. Red blood cell distribution width predicts gastrointestinal bleeding after coronary artery bypass grafting. BMC Cardiovasc Disord 2022; 22:436. [PMID: 36203150 PMCID: PMC9540710 DOI: 10.1186/s12872-022-02875-4] [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: 05/24/2022] [Accepted: 09/28/2022] [Indexed: 11/17/2022] Open
Abstract
Background Red blood cell distribution width (RDW) is highly associated with adverse clinical outcomes in many diseases. The present study aimed to evaluate the relationship between RDW and gastrointestinal bleeding (GIB) after isolated coronary artery bypass grafting (CABG). Methods This was a retrospective observational study that included 4473 patients who received CABG, and all the data were extracted from the Medical Information Mart for Intensive Care III database. Data collected included patient demographics, associated comorbid illnesses, laboratory parameters, and medications. The receiver operating characteristic (ROC) curve was used to determine the best cutoff value of RDW for the diagnosis of GIB. Multivariable logistic regression analysis was used to analyze the relationship between RDW and GIB. Results The incidence of GIB in patients receiving CABG was 1.1%. Quartile analyses showed a significant increase in GIB incidence at the fourth RDW quartile (> 14.3%; P < 0.001). The ROC curve analysis revealed that an RDW level > 14.1% measured on admission had 59.6% sensitivity and 69.4% specificity in predicting GIB after CABG. After adjustment for confounders, high RDW was still associated with an increased risk of GIB in patients with CABG (odds ratio = 2.83, 95% confidence interval 1.46–5.51, P = 0.002). Conclusions Our study indicates that the elevated RDW level is associated with an increased risk of GIB after CABG, and it can be an independent predictor of GIB. The introduction of RDW to study GIB enriches the diagnosis method of GIB and ensures the rapid and accurate diagnosis of GIB.
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Affiliation(s)
- Ying Liao
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Rongting Zhang
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.,The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Shanshan Shi
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.,The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Xueqin Lin
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.,The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Yani Wang
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.,The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Yun Wang
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Weihua Chen
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.,The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Yukun Zhao
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.,The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Kunming Bao
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.,The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Kaijun Zhang
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
| | - Liling Chen
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
| | - Yong Fang
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
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Latif A, Ahsan MJ, Lateef N, Kapoor V, Fazeel HM, Razzaq F, Iftikhar A, Ashfaq MZ, Anwer F, Mirza M, Kabach A. Prognostic Impact of Red Cell Distribution Width on the Development of Contrast-Induced Nephropathy, Major Adverse Cardiac Events, and Mortality in Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention. Curr Cardiol Rev 2021; 17:e051121191160. [PMID: 33563170 PMCID: PMC8950499 DOI: 10.2174/1573403x17666210204154812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 10/20/2020] [Accepted: 10/20/2020] [Indexed: 12/30/2022] Open
Abstract
Red cell distribution width (RDW) serves as an independent predictor towards the prognosis of coronary artery disease (CAD) in patients undergoing percutaneous coronary intervention (PCI). A systematic search of databases such as PubMed, Embase, Web of Science, and Cochrane library was performed on October 10th, 2019, to elaborate the relationship between RDW and in hospital and long term follow up, all-cause and cardiovascular mortality, major adverse cardiac events (MACE) and development of contrast-induced nephropathy (CIN) in patients with CAD undergoing PCI. Twenty-one studies qualified this strict selection criterion (number of patients = 56,425): one study was prospective, and the rest were retrospective cohorts. Our analysis showed that patients undergoing PCI with high RDW had a significantly higher risk of in-hospital all-cause mortality (OR 2.41), long-term all-cause mortality (OR 2.44), cardiac mortality (OR 2.65), MACE (OR: 2.16), and odds of developing CIN (OR: 1.42) when compared to the patients with low RDW. Therefore, incorporating RDW in the predictive models for the development of CIN, MACE, and mortality can help in triage to improve the outcomes in coronary artery disease patients who undergo PCI.
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Affiliation(s)
- Azka Latif
- Address correspondence to this author at the Department of Internal Medicine, Creighton University Medical Center, Omaha, Nebraska 7500, USA; Tel: 402-651-4961; E-mail:
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García-Escobar A, Grande Ingelmo JM. Red Cell Volume Distribution Width as Another Biomarker. Card Fail Rev 2019; 5:176-179. [PMID: 31777664 DOI: 10.15420/cfr.2019.13.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Danese E, Lippi G, Montagnana M. Red blood cell distribution width and cardiovascular diseases. J Thorac Dis 2015; 7:E402-11. [PMID: 26623117 DOI: 10.3978/j.issn.2072-1439.2015.10.04] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The red blood cell distribution width (RDW) is a rather simple measure of red blood cell (RBC) size heterogeneity (i.e., anisocytosis), which is easily calculated by dividing the standard deviation (SD) of erythrocyte volumes for the mean corpuscular volume (MCV). Emerging evidence suggests that, besides RBC abnormalities, many human disorders may be frequently associated with a high degree of anisocytosis. METHODS In this narrative review, we analyzed the current scientific literature about the putative role and the potential epidemiologic association between RDW and cardiovascular diseases. The findings of the most representative epidemiological studies were summarized and discussed. RESULTS Overall, considerable and convincing evidence has been brought that an increased RDW value is associated with acute coronary syndrome (ACS) [including acute myocardial infarction (AMI)], ischemic cerebrovascular disease (including stroke), peripheral artery disease (PAD), as well as with atrial fibrillation (AF), heart failure (HF) and hypertension. Higher anisocytosis also significantly and independently predicts adverse outcomes in patients with these conditions. CONCLUSIONS Although the role of anisocytosis in the pathogenesis of cardiovascular diseases remains uncertain, the considerable evidence available so far suggests that the clinical use of RDW may be broadened beyond the conventional boundaries of erythrocyte disorders, in particular for assisting the diagnosis and prognostication of patients with ACS, ischemic cerebrovascular disease, PAD, HF and AF.
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Affiliation(s)
- Elisa Danese
- Clinical Biochemistry Section, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy
| | - Giuseppe Lippi
- Clinical Biochemistry Section, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy
| | - Martina Montagnana
- Clinical Biochemistry Section, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy
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