Gonçalves Sara, Ferreira Santos José, Amador Pedro, Rassi Leandro, Rodrigues Ana Rita, Seixo Filipe, Neves Soares Luís
Serviço de Cardiologia, Centro Hospitalar de Setúbal, Setúbal, Portugal.
Rev Port Cardiol. 2013 Jan;32(1):27-33. doi: 10.1016/j.repc.2012.05.018. Epub 2012 Nov 30.
Higher values of red blood cell distribution width (RDW) have recently been associated with worse outcome in patients with cardiovascular disease. However, its relation to bleeding events in patients with non-ST elevation acute coronary syndromes has not been established.
To determine the prognostic value of RDW in patients with non-ST segment elevation acute coronary syndromes, particularly regarding the risk of major bleeding.
We analyzed 513 consecutive patients admitted with non-ST elevation acute coronary syndromes. The population was divided into tertiles of baseline RDW and clinical, laboratory characteristics and adverse events were analyzed for each group. The primary outcome was defined as the occurrence of major bleeding (according to the Crusade bleeding score). The predictive value of RDW for risk of major bleeding was determined.
The mean RDW was 15.13%±1.62%. Patients in the third tertile were older and more frequently had renal dysfunction or previous coronary revascularization. Higher values of RDW were associated with greater risk of major bleeding and in-hospital death. RDW >15.7% was an independent predictor of bleeding events (odds ratio 3.1, 95% CI 1.4-6.9).
In a population of patients with non-ST elevation acute coronary syndromes, RDW was associated with higher in-hospital mortality and was an independent predictor of in-hospital major bleeding.
近期研究表明，较高的红细胞分布宽度（RDW）值与心血管疾病患者的不良预后相关。然而，其与非ST段抬高型急性冠状动脉综合征患者出血事件的关系尚未明确。
确定RDW在非ST段抬高型急性冠状动脉综合征患者中的预后价值，尤其是关于大出血风险。
我们分析了513例连续收治的非ST段抬高型急性冠状动脉综合征患者。将患者按基线RDW三分位数分组，并对每组的临床、实验室特征及不良事件进行分析。主要结局定义为大出血的发生（根据Crusade出血评分）。确定RDW对大出血风险的预测价值。
平均RDW为15.13%±1.62%。三分位数最高组的患者年龄更大，肾功能不全或既往有冠状动脉血运重建史的比例更高。较高的RDW值与大出血和院内死亡风险增加相关。RDW>15.
