Wu Hengchao, Wang Xianqiang, Zhang Jing, Sun Hansong
State Key Laboratory of Cardiovascular Disease, Department of Adult Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.
J Card Surg. 2019 Oct;34(10):988-993. doi: 10.1111/jocs.14192. Epub 2019 Sep 3.
The effect of red blood cell distribution width (RDW) on long-term major cardiac and cardiovascular event (MACCE) in patients with off-pump coronary artery bypass (OPCAB) has not been adequately studied. We investigated the relationship between RDW and the risk of MACCE in patients who underwent OPCAB.
We retrospectively analyzed the data of 440 consecutive, nonanemic patients (362 males; 82.27% and mean age 60.8 ± 8.9 years) who underwent OPCAB between October 2009 and September 2012 in Fuwai Hospital. Long-term follow-up was obtained through phone calls, hospital records, and clinic visits. MACCE (death, ST elevated infarction, repeat coronary revascularization, stroke) was determined.
Over a median of 7.0-year follow-up, 80 incident MACCE events were identified. The RDW levels on admission were significantly higher in MACCE group than non-MACCE group (13.1 ± 0.7 vs 12.8 ± 0.7; P = .005). Using the Cox proportional hazards models, we found that per 1% increment of RDW, the incident of MACCE was increased in different models (hazard ratio [HR] was 1.520, 1.532, and 1.795, respectively; P = .002, .004, and .002). The receiver-operating characteristic analysis revealed an RDW cut-off value of 13% predicting MACCE. Therefore, patients were grouped on this cut-off value. The Kaplan-Meier plot revealed significantly lower event-free survival in the higher RDW group (P = .0158). Compared with subjects in the RDW <13% in full model, subjects in the RDW ≥13% had an HR of 1.829 (95% confidence interval, 1.103-3.032; P = .019).
An RDW level greater than 13% in hospital admission is independently associated with an increased incidence of long-term MACCE after OPCAB.
红细胞分布宽度（RDW）对非体外循环冠状动脉搭桥术（OPCAB）患者长期主要心脏和心血管事件（MACCE）的影响尚未得到充分研究。我们调查了接受OPCAB患者的RDW与MACCE风险之间的关系。
我们回顾性分析了2009年10月至2012年9月在阜外医院连续接受OPCAB的440例非贫血患者（362例男性；82.27%，平均年龄60.8±8.9岁）的数据。通过电话、医院记录和门诊随访进行长期随访。确定MACCE（死亡、ST段抬高型心肌梗死、再次冠状动脉血运重建、中风）。
在中位7.0年的随访中，共发现80例MACCE事件。MACCE组入院时的RDW水平显著高于非MACCE组（13.1±0.7 vs 12.8±0.7；P = 0.005）。使用Cox比例风险模型，我们发现RDW每增加1%，不同模型中MACCE的发生率都会增加（风险比[HR]分别为1.520、1.532和1.795；P = 0.002、0.004和0.002）。受试者工作特征分析显示，预测MACCE的RDW临界值为13%。因此，根据该临界值对患者进行分组。Kaplan-Meier曲线显示，较高RDW组的无事件生存率显著较低（P = 0.0158）。与全模型中RDW<13%的受试者相比，RDW≥13%的受试者HR为1.829（95%置信区间，1.103 - 3.032；P = 0.019）。
入院时RDW水平大于13%与OPCAB术后长期MACCE发生率增加独立相关。
