Zhao Kai, Li Yong-Jian, Gao Sheng
Department of Cardiology, Tianjin Nankai Hospital, Tianjin, China.
Coron Artery Dis. 2015 May;26(3):220-4. doi: 10.1097/MCA.0000000000000221.
It has been reported that increased red blood cell distribution width (RDW) predicts adverse events in cardiovascular disease and in patients undergoing percutaneous coronary intervention. However, the role of serum RDW levels in drug-eluting stent (DES) restenosis remains unclear. We aimed to investigate the relationship between serum RDW levels and in-stent restenosis (ISR) after coronary stenting with DES in stable angina pectoris (SAP) patients.
A total of 293 consecutive chronic SAP patients with coronary DES implantation were enrolled in this study. The ISR was analyzed by coronary angiography analysis at a mean follow-up of 8 months. According to whether ISR was detected, patients were divided into two groups: the ISR group (n=45) and the non-ISR group (n=247). Serum RDW was assessed both at admission and at the 8-month follow-up in all patients. Standard medication was continued throughout the investigation period.
Baseline characteristics of the two groups were similar. Patients in the ISR group had significantly higher RDW levels compared with patients in the non-ISR group both at admission and at follow-up (P<0.01, respectively). Furthermore, the ISR group had significantly longer stent length and lower stent diameter compared with the non-ISR group (P<0.01, respectively). In a multivariate analysis, diabetes mellitus, current smoking, RDW levels, C-reactive protein levels, stent length, and stent diameter were associated independently with ISR.
Serum RDW level may independently predict ISR at both admission and follow-up in SAP patients with coronary DES implantation, which indicates that a chronic inflammatory response might be involved in the pathogenesis of ISR.
据报道,红细胞分布宽度(RDW)升高可预测心血管疾病及接受经皮冠状动脉介入治疗患者的不良事件。然而,血清RDW水平在药物洗脱支架(DES)再狭窄中的作用仍不清楚。我们旨在研究稳定型心绞痛(SAP)患者冠状动脉DES植入术后血清RDW水平与支架内再狭窄(ISR)之间的关系。
本研究共纳入293例连续接受冠状动脉DES植入的慢性SAP患者。平均随访8个月时通过冠状动脉造影分析ISR情况。根据是否检测到ISR,将患者分为两组:ISR组(n = 45)和非ISR组(n = 247)。所有患者均在入院时及随访8个月时评估血清RDW。整个研究期间持续使用标准药物治疗。
两组的基线特征相似。ISR组患者在入院时及随访时的RDW水平均显著高于非ISR组患者(分别为P < 0.01)。此外,ISR组的支架长度显著长于非ISR组,支架直径显著小于非ISR组(分别为P < 0.01)。多因素分析显示,糖尿病、当前吸烟、RDW水平、C反应蛋白水平、支架长度和支架直径与ISR独立相关。
血清RDW水平可能在接受冠状动脉DES植入的SAP患者入院时及随访时独立预测ISR,这表明慢性炎症反应可能参与了ISR的发病机制。