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Hong RH, Zhu J, Li ZZ, Yuan J, Zhao P, Ding J, Fan QL, Yang J, Liu BG, Cai J, Zhu DS, Guan YT. Red blood cell distribution width is associated with neuronal damage in acute ischemic stroke. Aging (Albany NY) 2020; 12:9855-9867. [PMID: 32445553 PMCID: PMC7288978 DOI: 10.18632/aging.103250] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 04/20/2020] [Indexed: 12/16/2022]
Abstract
Elevated red blood cell distribution width (RDW) has been found to be associated with the occurrence of ischemic stroke. However, there is no defined relationship between RDW and neuronal damage in acute ischemic stroke (AIS). This study was designed to determine the relationship between RDW and neuronal damage in AIS patients. A total of 442 consecutive AIS patients from January 2018 to June 2019 were evaluated for neuronal damage, which was estimated by serum neuron-specific enolase (NSE) levels. Red blood cell distribution width-standard deviation (RDW-SD), a parameter that reflects the heterogeneity of red blood cell volume, was also assessed. We evaluated the association between the RDW-SD and serum NSE level through multivariate-adjusted linear regression analysis. Both the serum NSE level and the incidence of high NSE increased according to the increased RDW-SD tertile in AIS patients (p<0.01). There was a positive correlation between RDW-SD and serum NSE levels (r=0.275, 95% CI: 0.187-0.359, p<0.001). The beta coefficients (95% CI) between RDW-SD and serum NSE levels were 0.32 (0.21-0.42, p<0.001) and 0.26 (0.15-0.38, p<0.001), respectively, in AIS patients before and after adjusting for potential confounders. In conclusion, we found a significant positive association between RDW-SD and neuronal damage in AIS patients.
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Affiliation(s)
- Rong-Hua Hong
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China
| | - Jian Zhu
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China
| | - Ze-Zhi Li
- Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Jian Yuan
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China
| | - Pei Zhao
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China
| | - Jie Ding
- Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Qing-Lei Fan
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China
| | - Jin Yang
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China
| | - Bao-Guo Liu
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China
| | - Jian Cai
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China.,Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - De-Sheng Zhu
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China.,Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Yang-Tai Guan
- Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
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Wang L, Wang C, Wu S, Li Y, Guo W, Liu M. Red blood cell distribution width is associated with mortality after acute ischemic stroke: a cohort study and systematic review. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:81. [PMID: 32175374 DOI: 10.21037/atm.2019.12.142] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Whether red blood cell distribution width (RDW) is associated with the prognosis of acute ischemic stroke is inconclusive according to recent studies. We performed a cohort study and meta-analysis to explore the association between RDW and functional outcome. Methods Patients with ischemic stroke admitted to the Department of Neurology within 24 hours of stroke onset between January 1, 2015 to December 31, 2018 were enrolled. Blood was sampled within 24 hours after admission. We searched PubMed, Embase, Web of Science databases up to Nov 2019 to identify studies investigating the association between RDW values and prognosis following stroke. Outcomes included 3-month death and poor functional outcome [defined by modified Rankin Scale (mRS) score ≥3]. Results We included 1,558 patients in cohort study. RDW was independently associated with 3-month death [odds ratio (OR), 1.19; 95% confidence interval (CI), 1.03, 1.37], but not associated with 3-month poor outcome (OR 1.05, 95% CI, 0.95, 1.16), after adjustment for confounders. A dose-dependent relationship between RDW levels and 3-month death was revealed in the restricted cubic spline plot. Seven observational studies with 4,407 patients were identified for systematic review. When combining our study and previous studies, the association was significant for RDW predicting death (5 studies with 3,366 patients, OR 1.25, 95% CI, 1.15, 1.35), as well as for poor outcome (4 studies with 3,483 patients, OR 1.23, 95% CI, 1.05, 1.44). Conclusions RDW was an independent predictor of 3-month functional outcome, and a trend of dose-dependent relationship between RDW and 3-month death was detected.
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Affiliation(s)
- Lu Wang
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Changyi Wang
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Simiao Wu
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yuxiao Li
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Wen Guo
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ming Liu
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China
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Ransing RS, Patil B, Grigo O. Mean Platelet Volume and Platelet Distribution Width Level in Patients with Panic Disorder. J Neurosci Rural Pract 2019; 8:174-178. [PMID: 28479788 PMCID: PMC5402480 DOI: 10.4103/jnrp.jnrp_445_16] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Changes in platelet indices have been reported in patients with panic disorder (PD). However, previous study findings are contradictory and inconclusive. The aim of this study was to evaluate and compare the platelet indices in patients with PD. Materials and Methods: Patients with PD (n = 123) and healthy controls (n = 133) were enrolled in this case control study. The platelet indices (mean platelet volume [MPV] and platelet distribution width [PDW]) along with red blood cell (RBC) indices (RBC count and red cell distribution width [RDW]) were compared between the two groups using the unpaired t-test. Results: Patients with PD had lower MPV (7.53 ± 0.93 fL vs. 8.91 ± 1.24 fL, P < 0.0001), higher PDW (16.96 ± 0.85 fL vs. 14.71 ± 2.07 fL, P < 0.0001), and higher platelet count (274.2 ± 80.66 × 109 L−1 vs. 243.1 ± 93.89 × 109 L−1, P < 0.005) than the healthy controls. Furthermore, there were significant differences between patients with PD and healthy controls in terms of their RBC count (4.32 ± 0.56 × 1012 L−1 vs. 4.08 ± 0.80 × 1012 L−1, P = 0.007) and RDW (16.48 ± 2.26 fL vs. 15.01 ± 2.25 fL, P < 0.0001). Conclusion: Patients with PD have increased PDW and RDW. The platelet and RBC indices may prove to be useful etiological and prognostic markers in patients with PD.
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Affiliation(s)
- Ramdas Sarjerao Ransing
- Department of Psychiatry, B K L Walawalkar Rural Medical College, Ratnagiri, Maharashtra, India
| | - Bharat Patil
- Department of Psychiatry, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti-Solan, Himachal Pradesh, India
| | - Omityah Grigo
- Department of Pathology, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
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Abstract
Objective: To determine whether complete blood count parameters could be used as the biomarkers of inflammation in patients with in peripheral arterial disease. Methods: Seventy-five patients with peripheral arterial disease (study group) and 75 healthy subjects (control group) were included in this retrospective study. Their baseline clinical characteristics and laboratory data were recorded and compared. Data were compared using univariate tests including independent samples t-test, Mann-Whitney U-test and chi-square test. Moreover, multivariate logistic regression analysis was also conducted to determine independent predictors of peripheral arterial disease. Results: The groups were statistically similar with regards to baseline clinical and demographic features. The values of C-reactive protein, white blood cell and neutrophil-to-lymphocyte ratio values were found to be statistically significantly higher in study group versus control group, but none of them were considered as an independent predictor of peripheral arterial disease according to multivariate logistic regression analysis. Only mean platelet volume was demonstrated to be a statistically significant predictor of peripheral arterial disease. Conclusion: Our study deduced that mean platelet volume was an independent predictor of peripheral arterial disease, and could be used as a marker of inflammation in patients with peripheral arterial disease.
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Affiliation(s)
- Yusuf Velioglu
- a Faculty of Medicine, Department of Cardiovascular Surgery , Abant Izzet Baysal University , Bolu , Turkey
| | - Ahmet Yuksel
- a Faculty of Medicine, Department of Cardiovascular Surgery , Abant Izzet Baysal University , Bolu , Turkey
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Red Blood Cell Distribution Width Predicts 1-month Complications after Percutaneous Transluminal Angioplasty. J Med Biochem 2019; 38:468-474. [PMID: 31496911 PMCID: PMC6708289 DOI: 10.2478/jomb-2018-0047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 12/05/2018] [Indexed: 12/24/2022] Open
Abstract
Background The identification of patients at higher risk of developing percutaneous transluminal angioplasty (PTA)-related complications is pivotal for achieving better clinical outcomes. We carried out a single-center, observational, retrospective study to explore whether in-hospital changes of red blood cell distribution width (RDW) may help predicting early development of PTA-related complications. Methods The study population consisted of all consecutive patients who underwent PTA for severe peripheral artery occlusive disease (PAOD) during a 2-year period. RDW was measured at hospital admission and discharge, and the delta was calculated. Patient follow-up was routinely performed 1-month after hospital discharge, and was based on thoughtful medical assessment and arterial ultrasonography. The control population consisted of 352 ostensibly healthy subjects. Results The final PTA group consisted of 224 patients. Hemoglobin was lower, whilst mean corpuscular volume (MCV) and RDW were higher in PAOD cases than in controls. Overall, 11 PAOD patients (4.9%) developed clinically significant PTA-related complications 1-month after hospital discharge. Patients who developed 1-month PTA-related complications had lower hemoglobin concentration, but higher RDW and delta RDW than those who did not. Patients with delta RDW >1 had 60% higher risk of developing 1-month PTA-related complications and 88% higher risk of developing early reocclusion. Overall, RDW exhibited an area under the curve (AUC) of 0.68 and 0.74 for predicting 1-month PTA-related complications and early reocclusion, respectively. Conclusions The results of this study suggest that RDW may play a role for guiding the clinical decision making of PTA patients immediately after hospital discharge.
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Parizadeh SM, Jafarzadeh-Esfehani R, Bahreyni A, Ghandehari M, Shafiee M, Rahmani F, Parizadeh MR, Seifi S, Ghayour-Mobarhan M, Ferns GA, Avan A, Hassanian SM. The diagnostic and prognostic value of red cell distribution width in cardiovascular disease; current status and prospective. Biofactors 2019; 45:507-516. [PMID: 31145514 DOI: 10.1002/biof.1518] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/30/2019] [Indexed: 12/11/2022]
Abstract
The red blood cell distribution width (RDW) is an index of the heterogeneity of circulating red blood cell size, which along with other standard complete blood count (CBC) parameters are used to identify hematological system diseases. Besides hematological disorders, several clinical studies have shown that an increased in the RDW may be associated with other diseases including acute pancreatitis, chronic kidney disease, gastrointestinal disorders, cancer, and of special interest in this review, cardiovascular disease (CVD). The diagnostic and prognostic value of RDW in different CVD (acute coronary syndrome, ischemic cerebrovascular disease, peripheral artery disease, atrial fibrillation, heart failure, and acute ischemic stroke) has been reviewed in this article, to provide an understanding how its measurement may be applied to improve the management of these conditions.
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Affiliation(s)
- Seyed M Parizadeh
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Jafarzadeh-Esfehani
- Department of Medical Genetics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Bahreyni
- Department of Clinical Biochemistry and Immunogenetic Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran
| | - Maryam Ghandehari
- Student Research Committee, Faculty of Medicine, Islamic Azad University, Mashhad, Iran
| | - Mojtaba Shafiee
- Student Research Committee, Faculty of Medicine, Islamic Azad University, Mashhad, Iran
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzad Rahmani
- Department of Medical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammar R Parizadeh
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sima Seifi
- Department of Medical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Modern Sciences and Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Brighton, Sussex, UK
| | - Amir Avan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Modern Sciences and Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed M Hassanian
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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梁 琦, 雷 新, 李 红, 殷 艳, 任 洁, 范 力, 黄 欣, 袁 祖. [Regression analysis of red cell distribution width and mean platelet volume in patients with acute myocardial infarction]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2017; 37:1022-1027. [PMID: 28801280 PMCID: PMC6765727 DOI: 10.3969/j.issn.1673-4254.2017.08.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate clinical implications of changes in red cell distribution width (RDW) and mean platelet volume (MPV) in patients with acute myocardial infarction. METHODS A total of 127 patients (90 men and 37 women) were enrolled in this analysis, including 66 with acute myocardial infarction (AMI) and 61 with unstable angina (UA). The patients' baseline demographic and clinical data were compared between the two groups including age, hypertension, diabetes, smoking, BMI, blood biochemical profiles, cardiac functions and platelet and red blood cell parameters. The patients were further divided into subgroups according to the RDW 50% cumulative frequency, and the MPV, P-LCR, hsCRP, NT-proBNP, RBC, Dimer and MCV were compared. The correlations between platelet and erythrocyte test results were evaluated in both the AMI and UA patients. Regression analysis was performed to identify the factors affecting the RDW in the AMI group and a regression model was established. RESULTS The platelet and red blood cell test results, P-LCR, MPV, and RDW differed significantly between AMI and UA groups (P<0.01 or 0.05). Correlation analysis showed a significant positive correlation between RDW and MPV in AMI group (r=0.34, P<0.01). Between the subgroups with different RDW 50% cumulative frequencies, MPV, P-LCR, hsCRP, D-Dimer, and NT-proBNP all differed significantly (P<0.05 or 0.01). In AMI group, with RDW as the dependent variable, we established a multivariate regression model of RDW=0.19MPV+10.83. CONCLUSION RDW and MPV are closely correlated in patients with AMI. In multiple regression analysis, MPV can explain the changes in RDW in patients with AMI.
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Affiliation(s)
- 琦 梁
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 新军 雷
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 红兵 李
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 艳蓉 殷
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 洁 任
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 力宏 范
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 欣 黄
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 祖贻 袁
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
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Brief Report: Elevated Red Cell Distribution Width Identifies Elevated Cardiovascular Disease Risk in Patients With HIV Infection. J Acquir Immune Defic Syndr 2017; 74:298-302. [PMID: 27828877 DOI: 10.1097/qai.0000000000001231] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Red cell distribution width (RDW) is linked to cardiovascular risk in the general population, an association that might be driven by inflammation. Whether this relationship holds for patients with HIV infection has not been previously studied. Using a large clinical registry, we show that elevated RDW (>14.5%) is independently associated with increased risk of coronary artery disease {odds ratio [OR] 1.39 [95% confidence interval (CI): 1.25 to 1.55]}, peripheral vascular disease [OR 1.41 (95% CI: 1.29 to 1.53)], myocardial infarction [1.43 (95% CI: 1.25 to 1.63)], heart failure [OR 2.23 (95% CI: 1.99 to 2.49)], and atrial fibrillation [OR 1.96 (95% CI: 1.64 to 2.33)]. In conclusion, in the context of the inflammatory milieu that accompanies HIV infection, RDW remains a powerful marker of cardiovascular disease.
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Konishi T, Funayama N, Yamamoto T, Morita T, Hotta D, Nishihara H, Tanaka S. Prognostic Value of Eosinophil to Leukocyte Ratio in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. J Atheroscler Thromb 2016; 24:827-840. [PMID: 27904028 PMCID: PMC5556190 DOI: 10.5551/jat.37937] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aim: Leukocyte profile has been related to clinical outcome in patients with ST-segment elevation (STE) myocardial infarction (MI). However, whether eosinophil to leukocyte ratio (ELR) predicts clinical outcome in patients who have undergone primary percutaneous coronary intervention (PCI) remains unclear. Therefore, we examined the prognostic value of ELR in this patient population. Methods: We retrospectively analyzed the data of 331 consecutive patients who underwent primary PCI for STEMI between January 2009 and March 2015. All leukocyte types were counted and ELR was calculated for all patients 24 h after hospital admission. The primary study endpoint was major adverse cardiac events (MACEs) within up to one year of follow-up duration. Results: MACEs including cardiac deaths in 9.4% of the patients, MI in 1.5%, and target lesion or vessel revascularization in 10.3%, occurred within one year in 68 patients (20.5%). The mean ELR was significantly lower in patients with MACEs than in patients without MACEs (0.20 ± 0.51 vs. 0.49 ± 0.66, respectively; p < 0.001). An ELR < 0.1 at 24 h was identified as the best cut-off value for mortality prediction. Multivariate analysis identified that an ELR < 0.1 (odds ratio [OR] = 0.38; 95% confidence interval [CI] = 0.22–0.67; p < 0.001) and chronic kidney disease (OR = 2.38; CI = 1.33–4.24; p = 0.003) are independent predictors of MACEs. Conclusion: In primary PCI patients with STEMI, ELR at 24 h was an independent predictor of MACEs in addition to the usual coronary risk factors and commonly used biomarkers.
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Affiliation(s)
- Takao Konishi
- Department of Cardiology, Hokkaido Cardiovascular Hospital.,Department of Cancer Pathology, Hokkaido University School of Medicine
| | | | | | - Toru Morita
- Department of Cardiology, Hokkaido Cardiovascular Hospital
| | - Daisuke Hotta
- Department of Cardiology, Hokkaido Cardiovascular Hospital
| | - Hiroshi Nishihara
- Department of Cancer Pathology, Hokkaido University School of Medicine
| | - Shinya Tanaka
- Department of Cancer Pathology, Hokkaido University School of Medicine
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Bozan N, Alpaycı M, Aslan M, Cankaya H, Kıroglu AF, Turan M, Ayral A, Senkoy E, Ilter S. Mean platelet volume, red cell distribution width, platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios in patients with ankylosing spondylitis and their relationships with high-frequency hearing thresholds. Eur Arch Otorhinolaryngol 2016; 273:3663-3672. [PMID: 27034281 DOI: 10.1007/s00405-016-3980-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 03/09/2016] [Indexed: 12/30/2022]
Abstract
The mean platelet volume (MPV), red cell distribution width (RDW) and neutrophil-to-lymphocyte ratio (NLR) comprise laboratory markers in ankylosing spondylitis (AS). There is a controversy in the literature regarding which type of ear involvement is characteristic of AS. The aim of this study was to simultaneously investigate the MPV, RDW, platelet to lymphocyte (PLR) and NLR in patients with AS and their relationships with high-frequency hearing thresholds. Thirty patients with AS and 35 age-matched healthy subjects were included. Each subject was tested with low- (250, 500, 1000 and 2000 Hz) and high- (4000, 8000, 10,000, 12,000, 14,000 and 16,000 Hz) frequency audiometry. Additionally, the case and control groups were evaluated regarding the average hearing thresholds in bone conduction. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were measured. The RDW, MPV, neutrophils, lymphocytes and platelet counts were evaluated with the complete blood count. Furthermore, the NLR and PLR were calculated. The complete blood count, platelet numbers, ESR, CRP and NLR levels were significantly increased in the AS patients compared with the healthy controls (p < 0.001, p = 0.007, p < 0.001, p < 0.001 and p = 0.047, respectively). There was no statistically significant difference in the RDW, PLR or MPV levels (p > 0.05) in the AS patients compared with the healthy controls. The BASDAI score and disease duration were not correlated with the ESR, CRP levels, MPV, PLR, RDW or NLR in patients with AS (all; p > 0.05). The AS patients had increased average measurement values for the hearing threshold in both ears at frequencies of 250, 500, 1000 and 2000 Hz; however, there was no statistically significant difference (p > 0.05). The average values of the hearing threshold in both ears at the high frequencies of 4000, 6000, 8000, 10,000, 12,000 and 14,000 Hz were significantly increased in the case group; however, it was not significantly increased at 16,000 Hz. The current study is the first to investigate the PLR, NLR, MPV and RDW levels in acute AS. We identified a significantly increased NLR, leukocyte count, ESR and CRP in AS patients. Sensorineural hearing loss, especially at extended high frequencies, is common in patients with AS and may represent an extra-articular feature of the disease. The combined use of NLR with the leukocyte count and other clinical assessments may facilitate the diagnostic process of ankylosing spondylitis.
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Affiliation(s)
- Nazim Bozan
- Department of Otorhinolaryngology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Mahmut Alpaycı
- Physical Medicine and Rehabilitation, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Mehmet Aslan
- Department of Internal Medicine, Medical Faculty, Yuzuncu Yıl University, 6500, Van, Turkey.
| | - Hakan Cankaya
- Department of Otorhinolaryngology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Ahmet Faruk Kıroglu
- Department of Otorhinolaryngology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Mahfuz Turan
- Department of Otorhinolaryngology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Abdurrahman Ayral
- Department of Otorhinolaryngology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Emre Senkoy
- Physical Medicine and Rehabilitation, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Server Ilter
- Physical Medicine and Rehabilitation, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
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Lippi G, Buonocore R, Picanza A, Schirosa F, Cervellin G. Red blood cell distribution width and haemoglobin are associated with hospital admission in patients with acute allergic reactions. Br J Biomed Sci 2016; 73:21-4. [PMID: 27182672 DOI: 10.1080/09674845.2016.1140382] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Red blood cell distribution width (RDW) is significantly associated with a variety of human disorders. This study aimed to investigate whether RDW value at admission may predict the need of hospitalisation in patients presenting to the emergency department (ED) with acute allergic reactions. MATERIALS AND METHODS The study population consisted of adult patients (aged > 17) admitted to the ED for acute allergic reactions. RESULTS One hundred and thirty-two subjects were included, 12 of whom (9%) required hospital admission for severity of symptoms. Patients who needed hospital admission displayed significantly lower values of haemoglobin and significantly higher values of RDW-coefficient of variation (RDW-CV). In multivariate analysis, haemoglobin and RDW-CV were found to be independent predictors of hospital admission. The area under the curve (AUC), sensitivity and specificity for predicting hospital admission were 0.72, 0.88 and 0.42 for haemoglobin and 0.73, 0.88 and 0.50 for RDW-CV, respectively. The combination of these tests (both positive) was characterised by 0.76 AUC, 0.83 sensitivity, 0.67 specificity, 0.96 negative predictive value and 0.30 positive predictive. DISCUSSION The results of this study suggest that two common and inexpensive parameters such as haemoglobin and RDW are independent predictors of hospital admission in patients presenting to the ED with acute allergic reactions.
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Affiliation(s)
- Giuseppe Lippi
- a Section of Clinical Biochemistry , University of Verona , Verona , Italy
| | - Ruggero Buonocore
- b Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma , Parma , Italy
| | - Alessandra Picanza
- b Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma , Parma , Italy
| | - Fabio Schirosa
- c Emergency Department, Academic Hospital of Parma , Parma , Italy
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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.
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Ozdemir S, Barutcu A, Gazi E, Tan YZ, Turkon H. The Relationship Between Some Complete Blood Count Parameters and Myocardial Perfusion: A Scintigraphic Approach. World J Nucl Med 2015; 14:197-201. [PMID: 26420991 PMCID: PMC4564923 DOI: 10.4103/1450-1147.163253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Recent studies have shown that there is a relationship between some inflammatory and biochemical markers derived from complete blood count (CBC) such as neutrophil/lymphocyte (N/L) ratio, platelet/lymphocyte (P/L) ratio, platelet distribution width (PDW), red blood cell distribution width (RDW), and coronary artery disease (CAD). The aim of this study was to determine N/L ratio, P/L ratio, PDW values, and RDW values, which are associated with myocardial perfusion in patients diagnosed with CAD. This study included 262 patients (149 with myocardial ischemia/infarction and 113 with normal myocardial perfusion) undergoing myocardial perfusion scintigraphy (MPS) with CBC within 90 days of MPS. Myocardial perfusion parameters such as summed stress score and summed difference score (SDS) were compared with N/L ratio, P/L ratio, PDW values, and RDW values. Neutrophil counts and N/L ratios were significantly higher in patients diagnosed with myocardial ischemia and/or infarct. However, there was no statistically significant relationship between myocardial perfusion abnormalities and P/L ratio, PDW values, and RDW values. This study showed that N/L ratio is related to myocardial ischemia/infarction and correlated to left ventricular ejection fraction (LVEF).
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Affiliation(s)
- Semra Ozdemir
- Department of Nuclear Medicine, Canakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Ahmet Barutcu
- Department of Cardiology, Canakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Emine Gazi
- Department of Cardiology, Canakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Yusuf Ziya Tan
- Department of Nuclear Medicine, Canakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Hakan Turkon
- Department of Biochemistry, Canakkale Onsekiz Mart University, Çanakkale, Turkey
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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.
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Sertoglu E, Tapan S, Uyanik M. Important details about the red cell distribution width. J Atheroscler Thromb 2015; 22:219-20. [PMID: 25747554 DOI: 10.5551/jat.27573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
In the recent issue of the Journal of Atherosclerosis and Thrombosis, Wang et al. assessed the relationship between the red cell distribution width (RDW) and acute myocardial infarction (AMI). However, assessing all parameters affecting the RDW, determining the optimum RDW cut-off value for predicting the prognosis of coronary artery disease (CAD), excluding metabolic comorbidities affecting the RDW values and identifying the specific range for the WBC count within the exclusion criteria would provide more reliable results and improve the credibility of the entire article in this study population.
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Affiliation(s)
- Erdim Sertoglu
- Ankara Mevki Military Hospital, Anittepe Dispensary, Biochemistry Laboratory
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