title: Elevated red blood cell distribution width is associated with higher recourse to coronary artery bypass graft.
abstract: BACKGROUND
  Red blood cell distribution width (RDW) is a measure of heterogeneity in erythrocyte size used in the differential diagnosis of anemia. High levels are associated with elevated cardiovascular biomarkers and increased mortality. The hypothesis of this study is that high RDW levels on admission are associated with higher recourse to coronary artery bypass graft (CABG) in unstable angina (UA) or non-ST-elevation myocardial infarction (NSTEMI) patients.
  
  
  METHODS
  An observational, cross-sectional study of all adult patients undergoing coronary angiography admitted to an urban tertiary care center in 2007 with UA or NSTEMI was conducted. Data was gathered by review of inpatient charts. RDW was considered 'high' if it exceeded the 95th percentile (16.3%).
  
  
  RESULTS
  Among the 503 subjects included in the analysis, high RDW was independently associated with higher recourse to CABG versus a nonsurgical approach [OR = 2.39 (1.04-5.50); p = 0.041] but not with conservative management [OR = 0.97 (0.51-1.84); p = 0.922] or percutaneous coronary intervention [OR = 0.67 (0.36-1.25); p = 0.208].
  
  
  CONCLUSIONS
  This study of patients with UA or NSTEMI demonstrated an independent association of elevated RDW with higher recourse to CABG. RDW should be considered in the stratification of patients presenting with UA or NSTEMI.
authors.affiliation: Department of Cardiovascular Disease, North Shore--LIJ Health System, Manhasset, NY 11030, USA. g.ephrem@gmail.com
authors.forename: Georges
authors.initials: G
authors.lastname: Ephrem
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Kanei
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000097:blood* / Q000628:therapy; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000097:blood; D003430:Cross-Sectional Studies; D004906:Erythrocyte Count; D004909:Erythrocyte Indices / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000628:therapy; D062645:Percutaneous Coronary Intervention