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Red Blood Cell Distribution Width: A Risk Factor for Prognosis in Patients with Ischemic Cardiomyopathy after
Biyang Zhang1, Yinxiao Xu1, Xin Huang1
1Department of Cardiology, Capital Medical University Affiliated Anzhen Hospital, Beijing 100089, China.
Insights
Higher red blood cell distribution width (RDW) is linked to increased major adverse cardiovascular events (MACE) in ischemic cardiomyopathy patients after percutaneous coronary intervention (PCI). This finding highlights RDW as a significant prognostic marker for these patients.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Interventional Cardiology
Background:
- Red blood cell distribution width (RDW) is a known indicator of cardiovascular disease severity and prognosis.
- Previous studies suggest a correlation between RDW and adverse cardiovascular outcomes.
Purpose of the Study:
- To investigate the association between RDW and prognosis in ischemic cardiomyopathy (ICM) patients undergoing percutaneous coronary intervention (PCI).
- To determine if RDW can predict major adverse cardiovascular events (MACE) in this patient population.
Main Methods:
- Retrospective analysis of 1986 ICM patients who underwent PCI.
- Patients stratified into three groups based on RDW tertiles.
- Kaplan-Meier survival analysis, multivariate Cox regression, and restricted cubic spline (RCS) analysis were used to assess MACE and its components.
Main Results:
- Higher RDW tertiles were significantly associated with increased incidence of MACE, all-cause mortality, and revascularization.
- RDW independently predicted increased risks of MACE, all-cause mortality, and revascularization after adjusting for confounding variables.
- Nonlinear association between RDW and MACE was observed; elderly patients and those with hypercholesterolemia or without anemia showed higher MACE risk with elevated RDW.
Conclusions:
- RDW is a significant independent predictor of adverse cardiovascular outcomes in ICM patients undergoing PCI.
- Elevated RDW levels are associated with a higher risk of MACE in this cohort, suggesting its utility as a prognostic biomarker.
Background:
It has been demonstrated in previous studies that red blood cell distribution width (RDW) is correlated with the severity and prognosis of cardiovascular disease. The target of our study was to assess the relationship between RDW and the prognosis of ischemic cardiomyopathy (ICM) patients undergoing percutaneous coronary intervention (PCI).
Methods:
The study retrospectively enrolled 1986 ICM patients undergoing PCI. The patients were divided into three groups by RDW tertiles. The primary endpoint was major adverse cardiovascular events (MACE) and the secondary endpoints were each of the components of MACE (all-cause mortality, nonfatal myocardial infarction (MI) and any revascularization). Kaplan-Meier survival analyses were conducted to show the association between RDW and the incidence of adverse outcomes. The independent effect of RDW on adverse outcomes was determined by multivariate Cox proportional hazard regression analysis. In addition, the nonlinear relationship between RDW values and MACE was explored using restricted cubic spline (RCS) analysis. The relationship between RDW and MACE in different subgroups was determined using subgroup analysis.
Results:
As RDW tertiles increased, the incidences of MACE (Tertile 3 vs. Tertile 1: 42.6 vs. 23.7, p < 0.001), all-cause death (Tertile 3 vs. Tertile 1: 19.3 vs. 11.4, p < 0.001) and any revascularization (Tertile 3 vs. Tertile 1: 20.1 vs. 14.1, p < 0.001) increased significantly. The K-M curves showed that higher RDW tertiles were related to increased incidences of MACE (log-rank, p < 0.001), all-cause death (log-rank, p < 0.001) and any revascularization (log-rank, p < 0.001). After adjusting for confounding variables, RDW was proved to be independently associated with increased risks of MACE (Tertile 3 vs. Tertile 1: HR, 95% CI: 1.75, 1.43-2.15; p for trend < 0.001), all-cause mortality (Tertile 3 vs. Tertile 1: HR, 95% CI: 1.58, 1.17-2.13; p for trend < 0.001) and any revascularization (Tertile 3 vs. Tertile 1: HR, 95% CI: 2.10, 1.54-2.88; p for trend < 0.001). In addition, the RCS analysis suggested nonlinear association between RDW values and MACE. The subgroup analysis revealed that elderly patients or patients with angiotensin receptor blockers (ARBs) had a higher risk of MACE with higher RDW. Patients with hypercholesterolemia or without anemia also had a higher risk of MACE.
Conclusions:
RDW was significantly related to the increased risk of MACE among ICM patients undergoing PCI.
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