Red cell distribution width (RDW) and increased risk of recurrent acute coronary syndrome

Abstract

Objectives: Red cell distribution width (RDW) is associated with mortality in cardiopulmonary disorders such as coronary artery disease (CAD), acute coronary syndrome (ACS), heart failure, and acute pulmonary embolism. However, the little data that is available show the relationship between RDW and re-ACS after discharge in ACS patients. We aimed to investigate for relation between admission RDW and reACS related rehospitalization in ACS patients. Methods: A total of 400 consecutive patients with ACS were evaluated. In ROC curve analysis: optimal cutoff value of RDW to predict re-ACS was found as >14.0%, with 70% sensitivity and 62.5% specificity. Patients were categorized as having no increased (Group I) or increased (Group II) RDW based on a cut off value of 14.0%. Results: Mean age of patients was 63±12 years. Mean follow-up duration was 15±9 months and 80 patients rehospitalized with reACS. Among these 80 patients 24 (11%) patients belonged to Group I, and 56 (32%) patients were in Group II (p<0.001). Increased RDW > 14.0% on admission, presence of ST elevation MI, LV ejection fraction, and HDL cholesterol levels were found to have prognostic significance in univariate analysis. In multivariate Cox proportional-hazards model, only increased RDW > 14.0% on admission (HF=2.355, P=0.002), and previous ST elevation MI (HR: 1.906, P=0.024) remained associated with an increased risk of re-ACS. Furthermore, the mortality rate of the patients in the second group were significantly higher than those observed in the first group (4 (2%) vs 27 (15%), p<0.001). Conclusions: It seems RDW helps risk stratification in patients with ACS.