Increased red cell distribution width predicts occlusion of the infarct-related artery in STEMI

Area of Science:

• Cardiology
• Biomarkers
• Interventional Cardiology

Background:

• Infarct-related artery (IRA) patency is crucial for favorable outcomes in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI).
• Elevated Red Cell Distribution Width (RDW) is linked to adverse cardiovascular events and mortality in STEMI patients.

Purpose of the Study:

• To investigate the association between Red Cell Distribution Width (RDW) levels upon admission and infarct-related artery (IRA) patency.
• To evaluate RDW as a potential predictor of IRA patency in STEMI patients undergoing primary PCI.

Main Methods:

• A cohort of 564 STEMI patients undergoing primary PCI was analyzed.
• Patients were stratified into two groups based on pre-PCI Thrombolysis In Myocardial Infarction (TIMI) flow grade: occluded IRA (TIMI 0-1) and patent IRA (TIMI 2-3).
• Admission RDW, White Blood Cell (WBC) count, platelet count, creatine kinase-myocardial band (CK-MB), and troponin-I levels were assessed.

Main Results:

• Patients with an occluded IRA exhibited significantly higher RDW levels compared to those with a patent IRA (15.1 ± 1.7 vs. 13.4 ± 1.3, p < 0.001).
• Higher WBC count, platelet count, CK-MB, and troponin-I were also observed in the occluded IRA group (p < 0.05).
• RDW demonstrated significant positive correlations with troponin-I (r=0.397), CK-MB (r=0.344), and WBC count (r=0.219).
• Multivariate analysis identified RDW (OR: 0.483) and WBC count as independent predictors of IRA patency.

Conclusions:

• Admission RDW and WBC count are independent predictors of IRA patency in STEMI patients.
• RDW, being an easily accessible and cost-effective biomarker, holds potential for routine clinical use in predicting IRA patency.