Related Experiment Video
Updated: May 20, 2026
Dynamic Assessments of Coronary Flow Reserve after Myocardial Ischemia Reperfusion in Mice
Published on: August 25, 2023
The impact of admission red cell distribution width on the development of poor myocardial perfusion after primary
Turgay Isik1, Mustafa Kurt, Erkan Ayhan
1Department of Cardiology, Balikesir University, School of Medicine, Cagis Campus, Balikesir, Turkey. isikturgay@yahoo.com
Insights
Higher red cell distribution width (RDW) predicts no-reflow after primary percutaneous coronary intervention (PCI). This finding suggests RDW may help identify patients at risk for poor outcomes following PCI for ST-elevation myocardial infarction.
Area of Science:
- Cardiology
- Biomarkers
- Interventional Cardiology
Background:
- No-reflow phenomenon is a complication of primary percutaneous coronary intervention (PCI).
- Predictive markers for no-reflow are crucial for patient management.
- Red cell distribution width (RDW) is a measure of red blood cell size variation.
Purpose of the Study:
- To assess the predictive value of RDW for the electrocardiographic no-reflow phenomenon.
- To investigate the association between baseline RDW and no-reflow in ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI.
Main Methods:
- Prospective analysis of 100 STEMI patients treated with primary PCI.
- Measurement of RDW and high-sensitivity C-reactive protein (hs-CRP) on admission.
- Evaluation of ST-segment resolution (∑STR) 60 minutes post-PCI; ∑STR < 50% defined as no-reflow.
Main Results:
- No-reflow observed in 30% of patients.
- Higher admission RDW and hs-CRP levels in the no-reflow group.
- RDW ≥14% showed 70% sensitivity and 64% specificity for predicting no-reflow.
- Baseline RDW independently predicted no-reflow (OR 2.93) and mid-term mortality (OR 5.89).
Conclusions:
- Elevated baseline RDW is an independent predictor of electrocardiographic no-reflow post-PCI.
- RDW may serve as a valuable biomarker to identify patients at risk for no-reflow and adverse outcomes.
- Further research can explore RDW's role in guiding treatment strategies.
Background:
The purpose of this study was to evaluate the predictive value of red cell distribution width (RDW) on the electrocardiographic no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention (PCI).
Methods:
One-hundred consecutive patients (mean age 61.3 ± 12.8 years and male 77%) with ST-elevation myocardial infarction, who were treated with primary PCI, were analyzed prospectively. RDW and high sensitive C reactive protein (hs-CRP) were measured. The sum of ST-segment elevation was obtained immediately before and 60 min after the restoration of coronary flow. The difference between two measurements was accepted as the amount of ST-segment resolution and was expressed as ∑STR. ∑STR < 50% was accepted as electrocardiographic sign of no-reflow phenomenon.
Results:
There were 30 patients in the no-reflow group (Group 1) and 70 patients in the normal re-flow group (Group 2). RDW and hs-CRP levels on admission were higher in Group 1. An RDW level ≥14% measured on admission had 70% sensitivity and 64% specificity in predicting no-reflow on ROC curve analysis. Mid-term cardiovascular events were significantly higher in Group 1. In multivariate analyses, RDW (OR 2.93, <95% CI 1.42-6.04; p = 0.004), and tirofiban (OR 0.16, <95% CI 0.05-0.48; p = 0.001) were independent predictors of no-reflow, and RDW (OR 5.89, <95% CI 1.63-21.24; p = 0.007), and creatine kinase-MB (CK-MB) on admission (OR 1.01, <95% CI 1.00-1.02; p = 0.006) were independent predictors of mid-term mortality.
Conclusions:
A greater baseline RDW value was independently associated with the presence of electrocardiographic no-reflow.
