Abstract 13499: Red Cell Distribution Width is a Predictor of Mortality in Patients Undergoing Percutaneous Coronary Intervention
Introduction: Red cell distribution width (RDW), a measure of the variability of size of circulating erythrocytes, has been shown to be a marker of increased risk for coronary heart disease as well as an independent predictor of mortality in patients with CHF, CAD, prior stroke, in men referred for coronary angiography, in patients presenting with acute myocardial infarction (MI), and in non-anemic patients undergoing percutaneous coronary intervention (PCI).
Hypothesis: We hypothesized that RDW is a prognostic marker of death, MI and unplanned revascularization in a broad population undergoing PCI.
Methods: This post-hoc study investigates the prognostic value of RDW derived from a complete blood count (CBC) drawn < 24 hours of PCI in 1689 patients at 4 centers who underwent PCI between 2004 and 2007 and were included in the Evaluation of Drug Eluting Stents and Ischemic Events (EVENT) Registry. Patients who underwent blood transfusions were excluded. Multivariable analyses of death, MI, unplanned revascularization, and the combined occurrence of any of the aforementioned events at one year were performed using a logistic regression model, and ROC curves were established. The analysis was adjusted for creatinine ≥1.5, hemoglobin, history of coronary artery bypass grafting, male sex, BMI, atherosclerosis of ≥2 native coronary vessels, and hypertension.
Results: In univariate analysis, RDW in the highest quartile was a significant predictor of mortality (OR 5.62, 95% CI 2.29-13.82, p<0.001). In multivariate analysis, RDW was a predictor of 1 year mortality after PCI (OR 1.71, 95% CI 1.25- 2.35, p=0.001, AUC 0.79), independent of hemoglobin. RDW was not a predictor of MI by 1 year (OR0.94, 95% CI 0.74-1.20, p=0.63, AUC 0.66) or unplanned revascularization (OR 1.04, 95% CI 0.87-1.25, p=0.67, AUC 0.60). (Figure 1a-c)
Conclusions: RDW, an easily obtainable marker, has a strong independent linear relationship with 1 year mortality in a wide range of patients undergoing PCI.
- © 2011 by American Heart Association, Inc.