Abstract 14280: Impact of Change in Red Cell Distribution Width on Long-term Outcomes in Patients With Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
Introduction: High red cell distribution width (RDW) on admission has been shown to be associated with poor outcomes after acute myocardial infarction (AMI). However, the prognostic value of the change in RDW after AMI is unclear.
Hypothesis: In patients with AMI, the additional measurement of RDW 1 month later may facilitate risk stratification than a single measurement of RDW on admission.
Methods: We studied 509 patients with AMI undergoing primary percutaneous coronary intervention (PCI) within 12h after the onset. Patients were divided into the 4 groups based on whether RDW was within the normal range (≤14%) at admission and 1 month later: normal-normal (n=412, group N-N), normal-high (n=35, group N-H), high-normal (n=22, group H-N), and high-high (n=40, group H-H).
Results: There were no significant differences in sex, coronary risk factors, infarct site, times to admission and reperfusion, or final TIMI flow grade in the 4 groups. In groups N-N, N-H, H-N and H-H, age was 62±12, 70±12, 66±10, and 70±11 years; the rates of Killip class ≥2 on admission were 5%, 14%, 5%, and 18%; anemia on admission (defined as <12.0 g/dL in women and <13.0 g/dL in men) was 8%, 29%, 32% and 48%; and 3-vessel disease was 8%, 34%, 14%, and 15%; the levels of estimated glomerular filtration rate (eGFR) on admission was 74±20, 59±21, 69±24 and 73±31 ml/min/1.73m2; and peak creakine kinase was 3217±2450, 5165±5229, 3229±3084, and 2657±1709 IU/L; and adverse events (death, [re]infarction, or heart failure requiring rehospitalization) between 30 days and 3 years were 5%, 26%, 18%, and 23%, respectively (all p<0.001). Multivariate analysis showed that as compared with group N-N, hazard ratios (95% CI) for subsequent adverse events associated with groups N-H, H-N and H-H were 4.98 (2.09-11.0; p<0.001), 3.56 (1.02-9.52; p=0.046), and 4.01 (1.63-9.13; p=0.003), respectively.
Conclusions: In patients with AMI undergoing primary PCI, an increase in RDW from admission during 1 month was associated with long-term adverse outcomes, as well as transient and persistent high RDW. Our findings suggest that changes in RDW provide more prognostic information.
Author Disclosures: H. Nakahashi: None. M. Kosuge: None. M. Kiyokuni: None. T. Ebina: None. K. Hibi: Research Grant; Modest; AstraZeneca, MSD, Solve, Biosensors Japan, Teijin Pharma, Terumo, Mochida. Research Grant; Significant; Goodman, Medtronic Japan, St. Jude Medical Japan. Honoraria; Modest; Daiichi-Sankyo, Boston Scientific Japan. Consultant/Advisory Board; Modest; Terumo, St. Jude Medical Japan. N. Iwahashi: None. N. Maejima: None. Y. Matsuzawa: None. Y. Kimura: None. K. Kimura: Research Grant; Significant; Toa Eiyo Ltd, Bayer, MSD, Astellas, Sanofi, Eli Lilly Japan, Research Institute for Production Development, Pfizer, Shionogi, Kowa-souyaku, Daiichi-Sankyo, Mitsubishi Tanabe, Nihon-Boehringer-Ingelheim, Takeda, Otsuka, Ono. Honoraria; Modest; Astrazeneca, Toa Eiyo Ltd. Honoraria; Significant; MSD, Bayer, Daiichi-Sankyo .
- © 2016 by American Heart Association, Inc.