Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Dis Markers. 2022 Nov 3;2022:2193343. doi: 10.1155/2022/2193343. eCollection 2022.
Previous studies have shown that increased mean corpuscular volume (MCV) is an independent predictor for worse outcomes in coronary artery disease. However, as parameters to classify different types of anemia together with MCV, the relationship between mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and long-term outcomes in acute coronary syndrome (ACS) remains obscure. Moreover, few studies have compared the prognostic value of these red blood cell indices in anemic and nonanemic patients with ACS.
In this single-center observational cohort study, we enrolled 393 patients diagnosed with ACS, including 75 anemic and 318 nonanemic patients. The composite end points were defined as major adverse cardiovascular events (MACEs). After a median follow-up of 31.24 months, Kaplan-Meier survival analysis showed that higher MCV and MCH but not MCHC were significantly associated with increased MACEs in nonanemic ACS patients. Among the enrolled ACS patients without anemia, Cox regression analysis revealed that high MCV and MCH were correlated with increased MACEs after adjustment for cardiovascular risk factors, and receiver operating characteristic (ROC) curve analysis further confirmed the predictive value of high MCV and MCH. In bivariate correlation and linear regression analysis, plasma homocysteine was positively correlated with MCV and MCH but not MCHC in the nonanemic group even after adjusting for age, male sex, BMI, SBP, DBP, smoking, and diabetes. However, MCV, MCH, and MCHC showed no predictive value for MACEs, and no correlation was found between these red blood cell indices and homocysteine in ACS patients with anemia.
After adjusting for cardiovascular risk factors, this study showed that higher admission MCV and MCH but not MCHC were independent predictors for long-term MACEs and positively correlated with homocysteine levels in the blood among the nonanemic but not anemic patients with ACS in China.
先前的研究表明，平均红细胞体积（MCV）增加是冠心病不良结局的独立预测因素。然而，作为与 MCV 一起分类不同类型贫血的参数，平均红细胞血红蛋白（MCH）、平均红细胞血红蛋白浓度（MCHC）与急性冠状动脉综合征（ACS）的长期结局之间的关系尚不清楚。此外，很少有研究比较这些红细胞指数在贫血和非贫血 ACS 患者中的预后价值。
在这项单中心观察性队列研究中，我们纳入了 393 名诊断为 ACS 的患者，包括 75 名贫血患者和 318 名非贫血患者。复合终点定义为主要不良心血管事件（MACEs）。中位随访 31.24 个月后，Kaplan-Meier 生存分析显示，非贫血 ACS 患者中较高的 MCV 和 MCH 但不是 MCHC 与增加的 MACEs显著相关。在没有贫血的 ACS 患者中，Cox 回归分析显示，在校正心血管危险因素后，高 MCV 和 MCH 与增加的 MACEs相关，接受者操作特征（ROC）曲线分析进一步证实了高 MCV 和 MCH 的预测价值。在双变量相关和线性回归分析中，即使在校正年龄、性别、BMI、SBP、DBP、吸烟和糖尿病后，血浆同型半胱氨酸与非贫血组的 MCV 和 MCH 呈正相关，但与 MCHC 无关。然而，MCV、MCH 和 MCHC 对 MACEs 没有预测价值，贫血 ACS 患者中这些红细胞指数与同型半胱氨酸之间没有相关性。
在校正心血管危险因素后，本研究表明，较高的入院 MCV 和 MCH 但不是 MCHC 是中国非贫血但非贫血 ACS 患者长期 MACEs 的独立预测因素，与血液中的同型半胱氨酸水平呈正相关。
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