Veraldi Gian Franco, Mezzetto Luca, Scorsone Lorenzo, Macrì Marco, Simoncini Fabio, Lippi Giuseppe
Department of Vascular Surgery, University of Verona-School of Medicine, University Hospital of Verona, Verona, Italy.
Section of Clinical Biochemistry, University of Verona, Verona, Italy.
J Med Biochem. 2019 Jul 30;38(4):468-474. doi: 10.2478/jomb-2018-0047. eCollection 2019 Oct.
The identification of patients at higher risk of developing percutaneous transluminal angioplasty (PTA)-related complications is pivotal for achieving better clinical outcomes. We carried out a single-center, observational, retrospective study to explore whether in-hospital changes of red blood cell distribution width (RDW) may help predicting early development of PTA-related complications.
The study population consisted of all consecutive patients who underwent PTA for severe peripheral artery occlusive disease (PAOD) during a 2-year period. RDW was measured at hospital admission and discharge, and the delta was calculated. Patient follow-up was routinely performed 1-month after hospital discharge, and was based on thoughtful medical assessment and arterial ultrasonography. The control population consisted of 352 ostensibly healthy subjects.
The final PTA group consisted of 224 patients. Hemoglobin was lower, whilst mean corpuscular volume (MCV) and RDW were higher in PAOD cases than in controls. Overall, 11 PAOD patients (4.9%) developed clinically significant PTA-related complications 1-month after hospital discharge. Patients who developed 1-month PTA-related complications had lower hemoglobin concentration, but higher RDW and delta RDW than those who did not. Patients with delta RDW >1 had 60% higher risk of developing 1-month PTA-related complications and 88% higher risk of developing early reocclusion. Overall, RDW exhibited an area under the curve (AUC) of 0.68 and 0.74 for predicting 1-month PTA-related complications and early reocclusion, respectively.
The results of this study suggest that RDW may play a role for guiding the clinical decision making of PTA patients immediately after hospital discharge.
识别经皮腔内血管成形术(PTA)相关并发症发生风险较高的患者对于取得更好的临床结果至关重要。我们开展了一项单中心、观察性、回顾性研究,以探讨住院期间红细胞分布宽度(RDW)的变化是否有助于预测PTA相关并发症的早期发生。
研究人群包括在2年期间因严重外周动脉闭塞性疾病(PAOD)接受PTA的所有连续患者。在入院时和出院时测量RDW,并计算其差值。出院后1个月常规对患者进行随访,随访基于全面的医学评估和动脉超声检查。对照人群包括352名表面健康的受试者。
最终的PTA组包括224名患者。PAOD患者的血红蛋白较低,而平均红细胞体积(MCV)和RDW高于对照组。总体而言,11名PAOD患者(4.9%)在出院后1个月出现了具有临床意义的PTA相关并发症。出现1个月PTA相关并发症的患者血红蛋白浓度较低,但RDW和RDW差值高于未出现并发症的患者。RDW差值>1的患者发生1个月PTA相关并发症的风险高60%,发生早期再闭塞的风险高88%。总体而言,RDW预测1个月PTA相关并发症和早期再闭塞的曲线下面积(AUC)分别为0.68和0.74。
本研究结果表明,RDW可能在指导PTA患者出院后立即进行临床决策方面发挥作用。