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Relation of coronary collateral circulation with red cell distribution width in patients with non-ST elevation

Ibrahim Halil Tanboga1, Selim Topcu, Tuncer Nacar

  • 11Department of Cardiology, Heart Center, Ataturk University Medical School, Erzurum, Turkey.

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|December 25, 2012
PubMed

Insights

High red cell distribution width (RDW) is linked to impaired coronary collateral circulation (CCC) in non-ST elevation myocardial infarction (NSTEMI) patients. This finding may help predict poor CCC development in NSTEMI.

Area of Science:

  • Cardiology
  • Hematology

Background:

  • Coronary collateral circulation (CCC) plays a vital role in mitigating myocardial damage during non-ST elevation myocardial infarction (NSTEMI).
  • Assessing CCC is crucial for predicting outcomes in NSTEMI patients.

Purpose of the Study:

  • To investigate the association between red cell distribution width (RDW) and the quality of coronary collateral circulation (CCC) in patients diagnosed with NSTEMI.

Main Methods:

  • A cohort of 322 NSTEMI patients were analyzed.
  • Patients were categorized based on CCC quality using Rentrop grades: impaired (grades 0-1) and good (grades 2-3).
  • Red cell distribution width (RDW) was measured from complete blood count data.

Main Results:

  • Patients with impaired CCC exhibited significantly higher RDW values compared to those with good CCC (17.2 ± 2.3 vs. 14.5 ± 2.5, P < .001).
  • Multivariate analysis identified RDW (OR: 1.52, 95% CI: 1.30-1.78, P < .001) as an independent predictor of impaired CCC, alongside high creatine kinase MB (CK-MB) and absence of preinfarction angina.
  • Receiver-operating characteristic (ROC) analysis indicated an RDW cutoff of >15.5 had 77% sensitivity and 73% specificity for predicting impaired CCC (AUC = 0.783).

Conclusions:

  • Elevated RDW is an independent predictor of impaired coronary collateral circulation (CCC) in NSTEMI patients.
  • High RDW, elevated CK-MB, and the absence of preinfarction angina are significant predictors of poor CCC development.
  • RDW may serve as a valuable, readily available biomarker for assessing collateralization potential in NSTEMI.
Abstract

Keywords:
acute coronary syndromecoronary collateral circulationred cell distribution width

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