红细胞分布宽度作为接受直接经皮冠状动脉介入治疗的糖尿病合并ST段抬高型心肌梗死患者无复流现象的预测指标
RDW as A Predictor for No-Reflow Phenomenon in DM Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.
作者信息
Sun Ying, Ren Jian, Li Li, Wang Chunsong, Yao Hengchen
机构信息
Department of Cardiology, Liaocheng People's Hospital, Shandong University, Jinan 250012, China.
Department of Cardiology, Liaocheng People's Hospital Affiliated to Shandong First Medical University, Liaocheng 252000, China.
出版信息
J Clin Med. 2023 Jan 19;12(3):807. doi: 10.3390/jcm12030807.
BACKGROUND
No-reflow phenomenon (NRP) in ST-segment elevation myocardial infarction (STEMI) patients is not infrequent. The predictive value of red blood-cell distribution width (RDW) on NRP has not been explored.
METHODS
STEMI patients undergoing primary percutaneous coronary intervention (pPCI) were enrolled. Plasma samples were obtained at admission. Participants were divided into two groups according to RDW. Logistic regression and receiver operating characteristic (ROC) curve were performed to evaluate the relationship between RDW and NRP. Subgroup analysis was made between the diabetes mellitus (DM) group and the No-DM group.
RESULTS
The high RDW group had a higher NRP compared to the low group. In multivariate logistic regression analysis, DM (adjusted odds ratio [AOR]:1.847; 95% confidence interval [CI]: 1.209-2.822; = 0.005) and hemoglobin (AOR: 0.986; 95% CI: 0.973-0.999; < 0.05), other than RDW, were independent predictors of NRP. RDW (AOR: 2.679; 95% CI: 1.542-4.655; < 0.001) was an independent predictor of NRP in the DM group, but not in the No-DM group. In the DM group, area under the ROC curve value for RDW predicting NRP was 0.707 (77.3% sensitivity, 56.3% specificity ( < 0.001)).
CONCLUSIONS
RDW is a predictor of NRP in DM patients with STEMI, which provides further assistance in clinicians' decision making.
背景
ST段抬高型心肌梗死（STEMI）患者中无复流现象（NRP）并不少见。红细胞分布宽度（RDW）对NRP的预测价值尚未得到探讨。
方法
纳入接受直接经皮冠状动脉介入治疗（pPCI）的STEMI患者。入院时采集血浆样本。根据RDW将参与者分为两组。采用逻辑回归和受试者工作特征（ROC）曲线来评估RDW与NRP之间的关系。在糖尿病（DM）组和非DM组之间进行亚组分析。
结果
高RDW组的NRP发生率高于低RDW组。在多因素逻辑回归分析中，除RDW外，DM（调整后的优势比[AOR]：1.847；95%置信区间[CI]：1.209 - 2.822；P = 0.005）和血红蛋白（AOR：0.986；95%CI：0.973 - 0.999；P < 0.05）是NRP的独立预测因素。RDW（AOR：2.679；95%CI：1.542 - 4.655；P < 0.001）在DM组中是NRP的独立预测因素，但在非DM组中不是。在DM组中，RDW预测NRP的ROC曲线下面积值为0.707（敏感性77.3%，特异性56.3%（P < 0.001））。
结论
RDW是STEMI合并DM患者NRP的预测因素，可为临床医生的决策提供进一步帮助。
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