Khaki Siavash, Mortazavi Seyedeh Hamideh, Bozorgi Ali, Sadeghian Saeed, Khoshnevis Maryam, Mahmoodian Mehran
From the Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Crit Pathw Cardiol. 2015 Sep;14(3):112-5. doi: 10.1097/HPC.0000000000000047.
Coronary heart disease is the most common cause of death in most countries and also in Iran. Among novel prognostic markers suggested in recent studies for coronary heart disease, red blood cell distribution width (RDW) has been found to be associated with poor prognosis. Therefore, we aimed to evaluate the relationship between RDW and 6-month mortality and cardiovascular events after the initial attack of myocardial infarction (MI).
Medical records of 642 patients with MI were investigated for basic and clinical characteristics, as well as patients' first hemoglobin, RDW, and mean corpuscular volume at the time of admission. Then based on patients' time of hospitalization, they were followed up by telephone for readmission and mortality 6 months later.
Mean ± SD age of patients was 62.7 ± 12.7 years. In 6-month telephone follow-up, 443 patients (69%) had readmission. Six-month mortality occurred in 70 patients (10.9%). Patients with RDW level of 14.6% and higher were significantly older (P < 0.001). Three percent of patients with low RDW and 14.8% in high RDW group had renal failure (P < 0.001). Six-month mortality was observed in 24.3% of patients with high RDW and 7.9% of those with low RDW (P < 0.001). In multivariate logistic regression analysis, RDW (odds ratio: 1.98, 95% confidence interval: 1.06-3.68, P = 0.03), age, and ejection fraction were significant independent prognostic factors for mortality.
Six-month mortality was significantly higher in patients with MI with high RDW. Thus given that RDW is an inexpensive and available laboratory test, it could be used for mortality risk assessment and follow up the patients for stricter control of other modifiable risk factors.
冠心病是大多数国家以及伊朗最常见的死亡原因。在近期针对冠心病提出的新型预后标志物中，红细胞分布宽度（RDW）已被发现与预后不良相关。因此，我们旨在评估RDW与心肌梗死（MI）初次发作后6个月死亡率及心血管事件之间的关系。
对642例MI患者的病历进行调查，了解其基本和临床特征，以及患者入院时的首次血红蛋白、RDW和平均红细胞体积。然后根据患者的住院时间，通过电话对他们进行随访，了解6个月后的再入院情况和死亡率。
患者的平均年龄±标准差为62.7±12.7岁。在6个月的电话随访中，443例患者（69%）再次入院。70例患者（10.9%）出现6个月死亡率。RDW水平为14.6%及以上的患者年龄显著更大（P<0.001）。低RDW组3%的患者和高RDW组14.8%的患者出现肾衰竭（P<0.001）。高RDW组24.3%的患者和低RDW组7.9%的患者出现6个月死亡率（P<0.001）。在多因素逻辑回归分析中，RDW（比值比：1.98，95%置信区间：1.06 - 3.68，P = 0.03）、年龄和射血分数是死亡率的显著独立预后因素。
高RDW的MI患者6个月死亡率显著更高。因此，鉴于RDW是一种廉价且可获得的实验室检查，它可用于死亡率风险评估，并对患者进行随访，以便更严格地控制其他可改变的风险因素。
