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Submitted: 05 January 2017 Modified: 18 January 2017
HERDIN Record #: NCR-PHC-17010515240748

The prognostic value of red blood cell distribution width in predicting major adverse cardiovascular events among patients with acute coronary syndrome.

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Background: Red cell distribution width (RDW) is the quantitative measure of anisocytosis, the variability in size of the circulating erythrocytes. Although not previously correlated with cardiovascular outcomes, elevation of RDW has been associated with other disease process, including liver disease, malnutrition, occult cancer, and neoplastic metastases to marrow.


Methods: The study population consisted of 353 (67.5%) males and the mean age is 16.65 ± 12.276 years old. There were 76 subjects (14.5%) with unstable angina; 218 (41.7%) with non-ST elevation myocardial infarction. RDW value of ≥14.15 is most predictive of cardiovascular events with a sensitivity of 38.1% specificity of 76%, and kappa co-efficient of 0.107± 0.043. It further proves that RDW is an independent predictor of MACE as with Troponin I. However, high Troponin I values had a 2.502 times  ability to predict MACE than when it is low. High RDW on the other hand, had a 1.273 times ability to predict MACE when it is low. Nevertheless, when ACS patients presents with a negative Troponin I result the prognostic relevance of RDW cannot be of use.


Conclusion: RDW is an independent prognosticator of cardiovascular events among ACS patients. A cut-off score of ≥ 14.15 s most predictive of this condition.A positive Troponin I result enhances the prognostic relevance of RDW. These observations might lead to the rationale of introducing RDW as a part of the algorithm in cardiovascular risk prediction that would further enhance treatment guidelines in the future.


 

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