Red blood cell distribution width (RDW) and long-term survival in patients with ST elevation myocardial infarction

High RDW values are associated with adverse prognosis in many clinical conditions including short and medium term outcome of patients with ST Elevation Myocardial Infarction (STEMI). The aim of the present study was to evaluate the association between RDW and long term mortality in STEMI patients undergoing primary angioplasty (PPCI).

A cohort of 535 STEMI patients undergoing PPCI were divided into two groups (RDW > 14%, RDW ≤ 14%) using CHAID and CART methods. The association between RDW and 5-year all-cause mortality was assessed using Cox's proportional hazards analysis.

A total of 37 patients died during follow up of 5 years (mean: 1059, median: 1013, range 2-2130 days). RDW > 14% was associated with increased risk of all-cause mortality (HR = 5, CI 95% 2.7- 9.9, p < 0.001). In multivariate analysis, RDW > 14 remained significantly associated with increased risk for all-cause mortality (HR = 3.8, CI 95% 1.8- 7.99, p < 0.001). Patients with RDW above 14% did not have lower ejection fraction, higher CPK or more conventional risk factors.

RDW value above 14 is independently associated with increased long term all-cause mortality in patients with STEMI undergoing PPCI.