Red Cell Distribution Width and Mortality in Patients Undergoing Percutaneous Coronary Intervention
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Min-Tsun Liao1,2, Chao-Lun Lai1,2,3, Ting-Chuan Wang4
1Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 300, Taiwan.
Insights
Red cell distribution width (RDW) predicts mortality in coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI). Higher RDW levels showed a linear association with increased 1-year all-cause and cardiovascular mortality risks.
Area of Science:
- Cardiology
- Hematology
- Medical Informatics
Background:
- Red cell distribution width (RDW) is a measure of red blood cell volume variation.
- RDW is recognized for its prognostic value in various cardiovascular conditions.
- Limited research exists on the specific association between RDW and mortality post-percutaneous coronary intervention (PCI).
Purpose of the Study:
- To investigate the association between RDW and 1-year all-cause and cardiovascular mortality in patients undergoing PCI.
- To determine if this association is linear or non-linear.
- To establish RDW as a potential predictive biomarker in this patient population.
Main Methods:
- A multi-center, retrospective cohort study analyzing data from 2006 to 2017.
- Electronic medical records and health insurance claims data were utilized.
- Patients were stratified into five RDW groups, with multivariable logistic and Cox regression analyses performed.
Main Results:
- Analysis of 10,669 patients revealed a significant linear relationship between RDW and mortality.
- Increased RDW levels were independently associated with higher adjusted odds and hazard ratios for 1-year all-cause and cardiovascular mortality.
- The trend for increased mortality across higher RDW groups was statistically significant (p < 0.001 for all-cause, p = 0.015 for CV mortality).
Conclusions:
- RDW is an independent predictor of 1-year all-cause and cardiovascular mortality in patients following PCI.
- A linear relationship exists between RDW levels and mortality risk in this cohort.
- RDW presents a potentially valuable and clinically accessible parameter for risk stratification in PCI patients.
Abstract:
Red cell distribution width (RDW) can effectively predict prognosis in coronary artery disease (CAD) patients following percutaneous coronary intervention (PCI). There is currently no relevant research to demonstrate a linear or non-linear association between RDW and mortality. This is a multi-center, retrospective cohort study, with data collected from 2006 to 2017. Source data included electronic medical records of the Integrated Medical Database of National Taiwan University Hospital, and health insurance claims from the National Health Insurance Administration. Patients were stratified into five groups according to RDW values (13.4%, 14.1%, 14.8%, and 15.9%). Multivariable logistic and Cox regression analyses were used to determine 1-year all-cause and cardiovascular (CV) mortalities. Data of 10,669 patients were analyzed and those with the lowest RDW (≤13.3%) served as the reference group. The adjusted odds ratios (ORs) of 1-year all-cause mortality from the second to fifth RDW group were 1.386, 1.589, 2.090, and 3.192, respectively (p for trend < 0.001). The adjusted ORs of 1-year CV mortality were 1.555, 1.585, 1.623, and 2.850, respectively (p for trend = 0.015). The adjusted hazard ratios (HRs) of 1-year all-cause mortality were 1.394, 1.592, 2.003, and 2.689, respectively (p for trend = 0.006). The adjusted HRs of 1-year CV mortality were 1.533, 1.568, 1.609, and 2.710, respectively (p for trend = 0.015). RDW was an independent predicting factor and had a linear relationship with the 1-year all-cause and CV mortalities in patients undergoing PCI. Thus, RDW may be a clinically useful parameter to predict the mortality in those patients.
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