Red Cell Distribution Width Predicts Long-Term Cardiovascular Outcomes in Patients with Chronic Coronary Syndrome

Area of Science:

• Cardiology
• Hematology
• Clinical Medicine

Background:

• Red cell distribution width (RDW) is an established risk factor for cardiovascular mortality and heart failure.
• The prognostic value of RDW in patients with chronic coronary syndrome (CCS) undergoing percutaneous coronary intervention (PCI) requires further investigation.

Purpose of the Study:

• To evaluate the association between pre-procedural RDW and long-term clinical outcomes in patients with CCS undergoing their first PCI.
• To determine if RDW can serve as a predictor for adverse cardiovascular events in this patient population.

Main Methods:

• A cohort of 2,881 CCS patients who underwent first PCI between 2002 and 2016 with available pre-procedural RDW data were analyzed.
• Patients without anemia and severe renal dysfunction (n=1,827) were stratified into quartiles based on RDW.
• The primary endpoint was a composite of all-cause death and non-fatal myocardial infarction, assessed over a median follow-up of 6.2 years.

Main Results:

• Patients in higher RDW quartiles were older and more likely to have chronic kidney disease.
• The highest RDW quartile showed a significantly higher incidence of the primary endpoint (log-rank P = 0.0002).
• Increased RDW, both as quartiles and a continuous variable, was independently associated with a higher risk of cardiovascular events post-PCI (HR 1.95 for highest quartile; HR 1.46 per 1% increase).

Conclusions:

• Elevated pre-procedural RDW is associated with significantly worse long-term clinical outcomes, including death and myocardial infarction, in CCS patients after elective PCI.
• RDW may be a valuable, easily accessible biomarker for risk stratification in patients with chronic coronary syndrome undergoing PCI.