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Red cell distribution width predicts totally occluded infarct-related artery in NSTEMI
Sadık Kadri Açıkgöz1, Mehmet Kadri Akboğa1, Eser Açıkgöz2
1a Department of Cardiology , Turkiye Yüksek İhtisas Education and Research Hospital , Ankara , Turkey ;
Insights
Red cell distribution width (RDW) can help identify totally occluded infarct-related arteries (TO-IRA) in non-ST elevation myocardial infarction (NSTEMI) patients. Higher RDW levels are associated with TO-IRA, offering a simple predictive marker.
Area of Science:
- Cardiology
- Biomarkers
- Myocardial Infarction
Background:
- Totally occluded infarct-related artery (TO-IRA) in non-ST elevation myocardial infarction (NSTEMI) is linked to poorer patient prognosis.
- Red cell distribution width (RDW) and mean platelet volume (MPV) are emerging inflammatory markers with potential prognostic value in acute coronary syndromes.
Purpose of the Study:
- To investigate the association between RDW, MPV, and the presence of TO-IRA in patients diagnosed with NSTEMI.
- To identify independent predictors of TO-IRA among NSTEMI patients.
Main Methods:
- Analysis of data from 201 consecutive NSTEMI patients undergoing coronary angiography.
- Logistic regression analysis was employed to determine independent predictors of TO-IRA.
- Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of RDW.
Main Results:
- 32.8% of NSTEMI patients had TO-IRA.
- Patients with TO-IRA exhibited significantly higher RDW and troponin-T levels, and lower left ventricular ejection fraction (LVEF).
- RDW, troponin-T, LVEF, and circumflex artery (CX-IRA) involvement were identified as independent predictors of TO-IRA; MPV was not.
Conclusions:
- Red cell distribution width (RDW) demonstrates potential as a cost-effective and accessible biomarker for predicting TO-IRA in NSTEMI patients.
- MPV was not found to be an independent predictor of TO-IRA in this NSTEMI cohort.
Abstract:
Objective Since non-ST segment elevation myocardial infarction (NSTEMI) patients with totally occluded infarct-related artery (TO-IRA) have worse prognosis, it is important to recognize TO-IRA in NSTEMI. Red cell distribution width (RDW) and mean platelet volume (MPV) are novel markers of inflammation and oxidative stress and were associated with poor clinical outcomes in acute coronary syndrome. In the present study, association of RDW and MPV with the presence of TO-IRA in NSTEMI was investigated. Methods Data of 201 consecutive patients who underwent coronary angiography with a diagnosis of NSTEMI were analyzed. Independent predictors of TO-IRA were investigated with logistic regression analysis. Results Sixty-six (32.8%) of the patients had TO-IRA. In patients with TO-IRA, RDW and troponin-T were significantly higher and left ventricular ejection fraction (LVEF) was lower. MPV did not differ between groups. Circumflex (CX) IRA was more common in TO-IRA group. The ROC curve analysis showed that the RDW at a cut-point of 13.95% has 76% sensitivity and 66% specificity in detecting TO-IRA. RDW, troponin-T, LVEF and CX-IRA were independent predictors of TO-IRA in NSTEMI, but MPV was not. Conclusion RDW is a cheap and readily available marker that may have a role to predict TO-IRA in NSTEMI.
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