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Red blood cell distribution width and myocardial scar burden in coronary artery disease
Caroline Jane Magri1,2, Tan Xiao Tian3, Liberato Camilleri4
1Department of Cardiology, Mater Dei Hospital, Msida, Malta.
Insights
Increased red blood cell distribution width (RDW) is linked to greater myocardial scar burden and reduced left ventricular ejection fraction (LVEF) in patients with coronary artery disease. This finding highlights RDW as a significant predictor of cardiac damage.
Area of Science:
- Cardiology
- Hematology
- Biomarkers
Background:
- Red blood cell distribution width (RDW) is an emerging cardiovascular disease marker.
- RDW is associated with heart failure, coronary artery disease, and myocardial ischemia.
Purpose of the Study:
- To investigate the relationship between RDW and myocardial scar burden using MIBI viability scans.
- To assess the association between RDW and left ventricular ejection fraction (LVEF).
Main Methods:
- 123 patients with ischemic heart disease underwent myocardial viability scans.
- Evaluated parameters included RDW, hemoglobin, LVEF, and myocardial scarring.
- Multivariate analyses identified independent predictors of myocardial scarring and LVEF.
Main Results:
- RDW was an independent predictor of myocardial scarring (along with HDL-cholesterol and alanine transaminase).
- RDW was also an independent predictor of LVEF (along with MPV, LDL-cholesterol, and gamma-glutamyl transpeptidase).
- Median LVEF was 31% and median myocardial scarring was 8.7%.
Conclusions:
- Elevated RDW independently predicts myocardial scar burden in coronary artery disease patients.
- Increased RDW is also an independent predictor of impaired left ventricular function in this population.
Introduction:
Red blood cell distribution width (RDW) is a novel independent marker of cardiovascular disease including heart failure, coronary artery disease and myocardial ischaemia. The aim of the study was to investigate a possible relationship between RDW and myocardial scar burden, as assessed by a MIBI viability scan. A secondary objective was to assess whether there is an association between RDW and left ventricular ejection fraction (LVEF).
Methods:
The study comprised 123 subjects with ischaemic heart disease who underwent a myocardial viability scan between June 2008 and July 2014. Haemoglobin, mean corpuscular volume, RDW, platelet count, mean platelet volume (MPV), estimated glomerular filtration rate, fasting blood glucose, liver and lipid profiles were evaluated for all patients. The extent of myocardial scarring and LVEF were noted. Data were analysed using IBM SPSS Statistics 22.0. Univariate followed by multivariate analyses were performed to assess for independent predictors of myocardial scarring and LVEF, respectively.
Results:
The mean age of the study population was 63.5 years; most of the subjects were men. The median LVEF was 31% and median percentage of myocardial scarring was 8.7%. Multivariate analyses revealed that RDW, HDL-cholesterol and alanine transaminase were independent predictors of myocardial scarring while RDW, MPV, LDL-cholesterol and gamma-glutamyl transpeptidase were independent predictors of LVEF.
Conclusions:
Increased RDW is an independent predictor both of myocardial scar burden and of impaired left ventricular function in subjects with coronary artery disease.
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