Red blood cell distribution width and long-term outcome in patients undergoing percutaneous coronary intervention in the drug-eluting stenting era: a two-year cohort study.
BACKGROUND
Previous studies suggest the higher the red blood cell distribution width (RDW) the greater the risk of mortality in patients with coronary artery disease (CAD). However, the relationship between RDW and long-term outcome in CAD patients undergoing percutaneous coronary intervention (PCI) with a drug-eluting stent (DES) remains unclear. This study was designed to evaluate the long-term effect of RDW in patients treated with drug-eluting stent for CAD.


METHODS
In total of 2169 non-anemic patients (1468 men, mean age 60.2 ± 10.9 years) with CAD who had undergone successful PCI and had at least one drug-eluting stent were included in this study. Patients were grouped according to their baseline RDW: Quartile 1 (RDW<12.27%), Quartile 2 (12.27% ≤ RDW <13%), Quartile 3 (13% ≤ RDW<13.5%), and Quartile 4 (RDW ≥ 13.5).


RESULTS
The incidence of in-hospital mortality and death or myocardial infarction was significantly higher in Quartiles 3 and 4 compared with Quartile 1 (P<0.05). After a follow-up of 29 months, the incidence of all-cause death and stent thrombosis in Quartile 4 was higher than in Quartiles 1, 2, and 3 (P<0.05). The incidence of death/myocardial infarction/stroke and cardiac death in Quartile 4 was higher than in Quartiles 1 and 2 (P<0.05). Multivariate Cox regression analysis showed that RDW was an independent predictor of all-cause death (hazard ratio (HR) = 1.37, 95% confidence interval (CI) = 1.15-1.62, P<0.001) and outcomes of death/myocardial infarction/stroke (HR = 1.21, 95% CI = 1.04-1.39, P = 0.013). The cumulative survival rate of Quartile 4 was lower than that of Quartiles 1, 2, and 3 (P<0.05).


CONCLUSIONS
High RDW is an independent predictor of long-term adverse clinical outcomes in non-anemic patients with CAD treated with DES.
Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China.
Hai-Mu
HM
Yao
Department of Integrated ICU, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China.
Tong-Wen
TW
Sun
Department of Integrated ICU, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China.
Xiao-Juan
XJ
Zhang
Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China.
De-Liang
DL
Shen
Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China.
You-You
YY
Du
Department of Integrated ICU, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China.
You-Dong
YD
Wan
Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China.
Jin-Ying
JY
Zhang
Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China.
Ling
L
Li
Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China.
Luo-Sha
LS
Zhao
D000368:Aged; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000097:blood* / Q000401:mortality / Q000601:surgery*; D054855:Drug-Eluting Stents; D004909:Erythrocyte Indices; D004912:Erythrocytes; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome