title: Relation of red cell distribution width with the presence, severity, and complexity of coronary artery disease.
abstract: OBJECTIVE
  Red cell distribution width (RDW) is a measure of the heterogeneity of cell size in the peripheral blood and has been shown to be an independent correlate of adverse outcomes in healthy participants and in some cardiac conditions. We examined the association between RDW and the complexity of coronary artery disease (CAD).
  
  
  METHODS
  The study population included 193 nonanemic patients who had undergone coronary angiography for stable angina pectoris. Baseline RDW was measured as part of the automated complete blood count. Patients were classified depending on whether the SYNTAX score was 0 (no angiographically apparent CAD) or at least 1 where CAD was present angiographically.
  
  
  RESULTS
  Patients with angiographic CAD had significantly elevated RDW levels compared with the patients without CAD (14.4±1.3 vs. 12.5±0.9, P<0.001). There was a good correlation between RDW and the SYNTAX score (r=0.55, P<0.001). In a receiver operating characteristic curve analysis, an RDW value of 13.25 was identified as an effective cut-point in the segregation of the presence or absence of CAD [area under curve=0.87, 95% confidence interval (CI) 0.81-0.92]. An RDW value of more than 13.25 yielded a sensitivity of 84%, a specificity of 79%, a positive predictive value of 89%, and a negative predictive value of 71%. In multivariate analysis, RDW was observed to be an independent predictor for both angiographic CAD (odds ratio=4.80, 95% CI 2.41-9.57, P<0.001) and for a high (>32) SYNTAX score (odds ratio=2.28, 95% CI 1.45-3.60, P=0.01).
  
  
  CONCLUSIONS
  RDW is a readily available clinical laboratory value that is associated with both the presence and the complexity of CAD.
authors: Department of Cardiology, Erzurum Education and Research Hospital, Erzurum, Turkey. isikturgay@yahoo.com
authors: Turgay
authors: T
authors: Isik
authors: Huseyin
authors: H
authors: Uyarel
authors: Ibrahim Halil
authors: IH
authors: Tanboga
authors: Mustafa
authors: M
authors: Kurt
authors: Mehmet
authors: M
authors: Ekinci
authors: Ahmet
authors: A
authors: Kaya
authors: Erkan
authors: E
authors: Ayhan
authors: Mehmet
authors: M
authors: Ergelen
authors: Ednan
authors: E
authors: Bayram
authors: Charles Michael
authors: CM
authors: Gibson
mesh_terms: D000328:Adult; D000368:Aged; D060050:Angina, Stable / Q000097:blood / Q000209:etiology; D057205:Automation, Laboratory; D048429:Cell Size; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D004909:Erythrocyte Indices; D004912:Erythrocytes / Q000473:pathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014421:Turkey