Hematology and Hemorheology Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain.
Clin Hemorheol Microcirc. 2012;50(3):221-5. doi: 10.3233/CH-2011-1428.
In patients with acute myocardial infarction (AMI), high red blood cell distribution width (RDW) seems to predict further cardiovascular events, although the mechanism and its possible relation with anaemia and inflammation remains uncertain. We determined in 119 AMI patients before hospital discharge RDW, along with haemoglobin, haematimetric indices and inflammatory parameters (fibrinogen, C-reactive protein, plasma viscosity, neutrophil count). In the follow-up period (21 ± 11 months), 30 patients (25%) developed a recurrent cardiovascular event. In the lineal regression analysis, MCH and neutrophil count were independent determinants for RDW (beta coefficient = -0.544 p < 0.001; beta coefficient: 0.279 p = 0.001, respectively). The logistic regression analysis showed that RDW >14% increases the risk of future events by 6 times; OR 6.19 IC 95% (2.1-18.5); even after adjusting for anaemia, mean corpuscular haemoglobin (MCH) <27 pg/L, fibrinogen >400 mg/dL and neutrophil count >5.7 (103/μL). Our results confirm that RDW, an available and inexpensive measurement reported in routine blood cell counts, seems to be an independent predictor for recurrent cardiovascular events in AMI patients. As we found no association of RDW with either anaemia or inflammatory parameters, the mechanism responsible for increased RDW deserves further research.
在急性心肌梗死（AMI）患者中，高红细胞分布宽度（RDW）似乎可预测进一步的心血管事件，尽管其机制及其与贫血和炎症的可能关系尚不确定。我们在 119 例 AMI 患者出院前确定了 RDW 以及血红蛋白、血液学指标和炎症参数（纤维蛋白原、C 反应蛋白、血浆黏度、中性粒细胞计数）。在随访期间（21 ± 11 个月），30 例患者（25%）发生了复发性心血管事件。在线性回归分析中，MCH 和中性粒细胞计数是 RDW 的独立决定因素（β系数=-0.544，p<0.001；β系数：0.279，p=0.001）。逻辑回归分析显示，RDW>14%使未来事件的风险增加 6 倍；OR 6.19 95%CI（2.1-18.5）；即使在校正贫血、平均红细胞血红蛋白（MCH）<27pg/L、纤维蛋白原>400mg/dL 和中性粒细胞计数>5.7（103/μL）后也是如此。我们的结果证实，RDW 是常规血细胞计数中报告的一种可用且廉价的测量方法，似乎是 AMI 患者复发性心血管事件的独立预测因子。由于我们发现 RDW 与贫血或炎症参数均无关联，因此，导致 RDW 增加的机制值得进一步研究。
