Elevated Red Blood Cell Distribution Width Predicts Mortality and Major Adverse Cardiovascular Events After Acute...

Area of Science:

• Cardiology
• Hematology
• Clinical Outcomes Research

Background:

• Red blood cell distribution width (RDW) is a known prognostic biomarker in cardiovascular disease.
• Its independent prognostic value in acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI), especially independent of anemia, is not fully understood.

Purpose of the Study:

• To investigate the independent association of RDW with clinical outcomes in AMI patients treated with PCI.
• To evaluate RDW's prognostic value irrespective of anemia status.

Main Methods:

• A large-scale retrospective cohort study using the TriNetX US Collaborative Network (>105 million patients).
• Identified 84,811 adult AMI patients who underwent PCI and had RDW measured.
• Propensity score matching (1:1) was used to compare patients with high RDW (≥13.5%) versus low RDW (<13.5%) based on 38 baseline characteristics.
• Primary outcome: 1-year all-cause mortality. Secondary outcomes: Major Adverse Cardiovascular Events (MACE), heart failure, cardiogenic shock, recurrent AMI, cerebrovascular accident, ventricular tachycardia/fibrillation, and cardiac arrhythmia.

Main Results:

• After matching 32,010 pairs, high RDW was significantly associated with increased 1-year all-cause mortality (HR 1.77).
• High RDW also correlated with higher risks of MACE, heart failure, cardiogenic shock, recurrent AMI, cerebrovascular accident, and cardiac arrhythmia (all p < 0.01).
• These associations persisted in non-anemic patients (HR for mortality 1.67).

Conclusions:

• Elevated RDW is an independent predictor of mortality and adverse cardiovascular outcomes post-PCI in AMI patients.
• RDW provides prognostic information even in non-anemic individuals.
• RDW can be a valuable, accessible tool for early risk stratification in this patient population.