Red Blood Cell Distribution Width and Long-Term Outcome in Patients Undergoing Percutaneous Coronary Intervention in the Drug-Eluting Stenting Era: A Two-Year Cohort Study

Abstract

BackgroundPrevious studies suggest the higher the red blood cell distribution width (RDW) the greater the risk of mortality in patients with coronary artery disease (CAD). However, the relationship between RDW and long-term outcome in CAD patients undergoing percutaneous coronary intervention (PCI) with a drug-eluting stent (DES) remains unclear. This study was designed to evaluate the long-term effect of RDW in patients treated with drug-eluting stent for CAD.MethodsIn total of 2169 non-anemic patients (1468 men, mean age 60.2±10.9 years) with CAD who had undergone successful PCI and had at least one drug-eluting stent were included in this study. Patients were grouped according to their baseline RDW: Quartile 1 (RDW<12.27%), Quartile 2 (12.27%≤RDW<13%), Quartile 3 (13%≤RDW<13.5%), and Quartile 4 (RDW≥13.5).ResultsThe incidence of in-hospital mortality and death or myocardial infarction was significantly higher in Quartiles 3 and 4 compared with Quartile 1 (P<0.05). After a follow-up of 29 months, the incidence of all-cause death and stent thrombosis in Quartile 4 was higher than in Quartiles 1, 2, and 3 (P<0.05). The incidence of death/myocardial infarction/stroke and cardiac death in Quartile 4 was higher than in Quartiles 1 and 2 (P<0.05). Multivariate Cox regression analysis showed that RDW was an independent predictor of all-cause death (hazard ratio (HR) = 1.37, 95% confidence interval (CI) = 1.15–1.62, P<0.001) and outcomes of death/myocardial infarction/stroke (HR = 1.21, 95% CI = 1.04–1.39, P = 0.013). The cumulative survival rate of Quartile 4 was lower than that of Quartiles 1, 2, and 3 (P<0.05).ConclusionHigh RDW is an independent predictor of long-term adverse clinical outcomes in non-anemic patients with CAD treated with DES.

The Association Between Red Cell Distribution Width and Stroke in Patients with Atrial Fibrillation

“…6 However, in recent years red cell distribution width has emerged as a novel predictor, particularly of cardiovascular morbidity and mortality. [7][8][9][10][11] More recent studies have revealed that red cell distribution width is an independent predictor of all-cause mortality in the general population of adults aged ≥45. 12 In this study we aimed to assess the association between red cell distribution width and stroke incidence in patients with atrial fibrillation, and to examine whether accounting for red cell distribution width may improve the predictive accuracy for stroke with the most widely used risk stratification scores.…”

Red cell distribution width and mortality in carotid atherosclerosis

“…In addition, Tonelli et al [2] showed similar results in patients with coronary artery disease (CAD) as RDW levels were significantly associated with mortality and cardiovascular events, including stroke. Recently, these findings were confirmed in several studies [3][4][5]. Veeranna et al [5] measured RDW and high-sensitive C-reactive protein (hsCRP) in 8513 patients free of cardiovascular disease who were followed for 2-7 years.…”

“… showed similar results in patients with coronary artery disease (CAD) as RDW levels were significantly associated with mortality and cardiovascular events, including stroke. Recently, these findings were confirmed in several studies . Veeranna et al .…”

Red Cell Distribution Width as a Marker of Inflammation in Type 2 Diabetes Mellitus

“…One of the markers that have recently received considerable attention for its role in diabetes is RDW. RDW is a quantitative measure of the heterogeneity circulating red blood cell size, and is normally assessed in the differential diagnosis of anemia [8] RDW is effectively a free test that, is reported beside a complete blood count without extra cost by well prognostic value [7] . So this study of RDW and type 2 diabetes in order to evaluate capability of RDW as a novel prognostic marker in diabetic patients.…”