1
|
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.
Collapse
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:
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Liao MT, Lai CL, Wang TC, Lin JW, Ho YL, Chan KA. Red Cell Distribution Width and Mortality in Patients Undergoing Percutaneous Coronary Intervention. Biomedicines 2021; 10:biomedicines10010045. [PMID: 35052725 PMCID: PMC8772904 DOI: 10.3390/biomedicines10010045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 12/23/2022] Open
Abstract
Red cell distribution width (RDW) can effectively predict prognosis in coronary artery disease (CAD) patients following percutaneous coronary intervention (PCI). There is currently no relevant research to demonstrate a linear or non-linear association between RDW and mortality. This is a multi-center, retrospective cohort study, with data collected from 2006 to 2017. Source data included electronic medical records of the Integrated Medical Database of National Taiwan University Hospital, and health insurance claims from the National Health Insurance Administration. Patients were stratified into five groups according to RDW values (13.4%, 14.1%, 14.8%, and 15.9%). Multivariable logistic and Cox regression analyses were used to determine 1-year all-cause and cardiovascular (CV) mortalities. Data of 10,669 patients were analyzed and those with the lowest RDW (≤13.3%) served as the reference group. The adjusted odds ratios (ORs) of 1-year all-cause mortality from the second to fifth RDW group were 1.386, 1.589, 2.090, and 3.192, respectively (p for trend < 0.001). The adjusted ORs of 1-year CV mortality were 1.555, 1.585, 1.623, and 2.850, respectively (p for trend = 0.015). The adjusted hazard ratios (HRs) of 1-year all-cause mortality were 1.394, 1.592, 2.003, and 2.689, respectively (p for trend = 0.006). The adjusted HRs of 1-year CV mortality were 1.533, 1.568, 1.609, and 2.710, respectively (p for trend = 0.015). RDW was an independent predicting factor and had a linear relationship with the 1-year all-cause and CV mortalities in patients undergoing PCI. Thus, RDW may be a clinically useful parameter to predict the mortality in those patients.
Collapse
Affiliation(s)
- Min-Tsun Liao
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 300, Taiwan;
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan; (J.-W.L.); (Y.-L.H.)
| | - Chao-Lun Lai
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 300, Taiwan;
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan; (J.-W.L.); (Y.-L.H.)
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 100, Taiwan
- Correspondence: ; Tel.: +886-3-5326151
| | - Ting-Chuan Wang
- Health Data Research Center, National Taiwan University, Taipei 100, Taiwan; (T.-C.W.); (K.A.C.)
| | - Jou-Wei Lin
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan; (J.-W.L.); (Y.-L.H.)
- Cardiovascular Center, National Taiwan University Hospital Yunlin Branch, Douliu City 640, Taiwan
| | - Yi-Lwun Ho
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan; (J.-W.L.); (Y.-L.H.)
- Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
| | - K. Arnold Chan
- Health Data Research Center, National Taiwan University, Taipei 100, Taiwan; (T.-C.W.); (K.A.C.)
- Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| |
Collapse
|
3
|
Wu X, Ma C, Sun D, Zhang G, Wang J, Zhang E. Inflammatory Indicators and Hematological Indices in Contrast-Induced Nephropathy Among Patients Receiving Coronary Intervention: A Systematic Review and Meta-Analysis. Angiology 2021; 72:867-877. [PMID: 33719591 DOI: 10.1177/00033197211000492] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Strong inflammatory indicators such as C-reactive protein (CRP), high-sensitivity CRP (hsCRP), and hematological indices, including platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), hematocrit (HCT), and red blood cell distribution width (RDW), may be related with contrast-induced nephropathy (CIN). Our meta-analysis aimed at exploring the relationship between these indicators and CIN incidence among patients undergoing coronary intervention. Clinical studies were retrieved from the electronic databases of PubMed, EMBASE, Google Scholar, Clinical Trials, and Science Direct from their inception to June 3, 2020. Meta-analysis was performed on pooled eligible studies. Finally, 26 studies involving 29 454 patients were included. Pooled analysis revealed that patients with higher CRP (odds ratio [OR] = 1.06, 95% CI: 1.01-1.12, P = .02), hsCRP (OR = 1.03, 95% CI: 1.01-1.06, P = .004), NLR (OR = 1.11, 95% CI: 1.01-1.20, P = .02), RDW (OR = 1.35, 95% CI: 1.19-1.53, P < .001), and lower HCT (OR = 0.94, 95% CI: 0.92-0.97, P = .003) all exhibited significantly higher CIN rates, but there was no significant association between PLR and CIN risk (OR = 1.12, 95% CI: 0.99-1.26, P = .07). Pre-angiography CRP/hsCRP and some hematological indices are associated with CIN.
Collapse
Affiliation(s)
- Xiaoyan Wu
- Department of Pediatric Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Chao Ma
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Daqing Sun
- Department of Pediatric Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Guojing Zhang
- Department of Pediatric Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Jinmiao Wang
- Department of Pediatric Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Enyuan Zhang
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| |
Collapse
|
4
|
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
|
5
|
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
|
6
|
Long-term Pattern of Red Cell Distribution Width in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Crit Pathw Cardiol 2019; 19:43-48. [PMID: 31478946 DOI: 10.1097/hpc.0000000000000196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Red cell distribution width (RDW) is an indirect marker of inflammation and an independent predictor of long-term mortality. The aim of this study was to determine RDW values in patients with ST-elevation acute myocardial infarction (STEMI) submitted to primary percutaneous coronary intervention (PCI) and evaluate its association with adverse outcomes. We measured RDW in STEMI patients before undergoing primary PCI and divided into low and high RDW. Patients were followed up to 3 years after their discharge for the occurrence of in-hospital, 30-days, and long-term major adverse cardiovascular events (MACEs) and mortality. We included 485 patients with a mean age of 61.1(±12.5) years, 62.9% were male. In multivariate analysis, RDW remained independent predictor of long-term mortality and MACE [relative risk (RR) 1.51; 95% confidence interval (95% CI) = 1.11-2.05; P = 0.007 and RR = 1.42; 95% CI = 1.30-1.82; P = 0.004. Area under the curve for long-term mortality was 0.65 (95% CI = 0.61-0.69; P < 0.0001). RDW < 13.4 had a negative predictive value of 87.4% for all-cause mortality. Patients who had worse outcomes remained with higher values of RDW during the follow-up. In conclusion, high RDW is an independent predictor of long-term mortality and MACE in patients with STEMI undergoing primary PCI. A low RDW has an excellent negative predictive value for long-term mortality. Patients with sustained elevated levels of RDW have worse outcomes at long-term follow-up.
Collapse
|
7
|
Elhosseiny S, Akel T, Mroue J, Tathineni P, El Sayegh S, Lafferty J. The Value of Adding Red Cell Distribution Width to Mehran Risk Score to Predict Contrast-induced Acute Kidney Injury in Patients with Acute Coronary Syndrome. Cureus 2018; 10:e2911. [PMID: 30186716 PMCID: PMC6122680 DOI: 10.7759/cureus.2911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background: Contrast-induced acute kidney injury (CI-AKI) is a relatively reversible cause of acute kidney injury (AKI) that occurs after radiocontrast media administration. It is a common complication after percutaneous coronary intervention, especially in patients with acute coronary syndrome (ACS). The aim of this study is to determine the utility of red cell distribution width (RDW) in predicting CI-AKI in patients with ACS and to determine the value of adding RDW to the Mehran risk score (MRS) on admission. Methods: A total of 161 patients who presented with ST-elevation myocardial infarction (STEMI) or non-STEMI were identified retrospectively between January 2015 and December 2016. Patients were divided into two groups, those who developed CI-AKI after percutaneous coronary intervention (PCI) and those who did not. Results: A total of 161 patients were analyzed. Of them, 12 developed CI-AKI (eight presented with STEMI and four presented with non-STEMI). RDW did not correlate with the development of CI-AKI (14.55 ± 1.48 vs 14.83 ± 1.21; p = 0.072). The areas under the receiver operating characteristic curves (ROCs) for RDW, MRS, and the combined model (MRS and RDW) for the prediction of CI-AKI were 0.721 (95% confidence interval (CI), 0.645 to 0.788; p=0.0024), 0.885 (95% CI, 0.825 to 0.930; p<0.0001), 0.890 (95% CI, 0.831 to 0.933; p<0.0001), respectively. Pairwise comparisons between ROCs for MRS vs the combined model yielded a non-significant p-value of 0.49. This signifies no added benefit for RDW to MRS for predicting CI-AKI. Conclusion: RDW does not correlate with the development of CI-AKI in patients with ACS. The Mehran risk score remains a better indicator of CI-AKI risk assessment with no role for the addition of RDW to it. Further studies are needed to better assess predictors of CI-AKI in patients undergoing percutaneous coronary intervention.
Collapse
Affiliation(s)
- Sherif Elhosseiny
- Internal Medicine, Staten Island University Hospital, Staten Island, USA
| | - Tamer Akel
- Internal Medicine, Staten Island University Hospital, Staten Island, USA
| | - Jad Mroue
- Internal Medicine, Staten Island University Hospital, Staten Island, USA
| | | | | | - James Lafferty
- Cardiology, Staten Island University Hospital, Staten Island, USA
| |
Collapse
|