title: The impact of admission red cell distribution width on the development of poor myocardial perfusion after primary percutaneous intervention.
abstract: BACKGROUND
  The purpose of this study was to evaluate the predictive value of red cell distribution width (RDW) on the electrocardiographic no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  One-hundred consecutive patients (mean age 61.3 ± 12.8 years and male 77%) with ST-elevation myocardial infarction, who were treated with primary PCI, were analyzed prospectively. RDW and high sensitive C reactive protein (hs-CRP) were measured. The sum of ST-segment elevation was obtained immediately before and 60 min after the restoration of coronary flow. The difference between two measurements was accepted as the amount of ST-segment resolution and was expressed as ∑STR. ∑STR < 50% was accepted as electrocardiographic sign of no-reflow phenomenon.
  
  
  RESULTS
  There were 30 patients in the no-reflow group (Group 1) and 70 patients in the normal re-flow group (Group 2). RDW and hs-CRP levels on admission were higher in Group 1. An RDW level ≥14% measured on admission had 70% sensitivity and 64% specificity in predicting no-reflow on ROC curve analysis. Mid-term cardiovascular events were significantly higher in Group 1. In multivariate analyses, RDW (OR 2.93, <95% CI 1.42-6.04; p = 0.004), and tirofiban (OR 0.16, <95% CI 0.05-0.48; p = 0.001) were independent predictors of no-reflow, and RDW (OR 5.89, <95% CI 1.63-21.24; p = 0.007), and creatine kinase-MB (CK-MB) on admission (OR 1.01, <95% CI 1.00-1.02; p = 0.006) were independent predictors of mid-term mortality.
  
  
  CONCLUSIONS
  A greater baseline RDW value was independently associated with the presence of electrocardiographic no-reflow.
authors: Department of Cardiology, Balikesir University, School of Medicine, Cagis Campus, Balikesir, Turkey. isikturgay@yahoo.com
authors: Turgay
authors: T
authors: Isik
authors: Mustafa
authors: M
authors: Kurt
authors: Erkan
authors: E
authors: Ayhan
authors: Ibrahim Halil
authors: IH
authors: Tanboga
authors: Mehmet
authors: M
authors: Ergelen
authors: Huseyin
authors: H
authors: Uyarel
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D004909:Erythrocyte Indices; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D054318:No-Reflow Phenomenon; D062645:Percutaneous Coronary Intervention
chemical_list: D002097:C-Reactive Protein