title: Additional value of the red blood cell distribution width to the Mehran risk score for predicting contrast-induced acute kidney injury in patients with ST-elevation acute myocardial infarction.
abstract: BACKGROUND
  Contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention in patients with ST-elevation myocardial infarction (STEMI) is a common complication associated with worse outcome. Considering the prognostic predictive value of the red cell distribution width (RDW), we aimed to measure the usefulness of RDW for predicting CI-AKI.
  
  
  METHODS
  All consecutive STEMI patients without hemodialysis from June 2011 to September 2013 admitted to St. Luke's International Hospital were enrolled. We performed primary percutaneous coronary intervention in all patients. CI-AKI was defined as a >25% increase or an absolute increase in serum creatinine of 0.5mg/dl within 3 days after percutaneous coronary intervention. The potential additional predictive value of RDW with the Mehran risk score (MRS) on admission was estimated.
  
  
  RESULTS
  A total of 102 patients (78.4% males) were analyzed - 10 of the 102 (10%) STEMI patients developed CI-AKI. Multivariate analysis showed that RDW was an independent variable predicting CI-AKI in these patients [odds ratio, 2.029; 95% confidence interval (95% CI), 1.029-3.999; p=0.041]. The areas under the receiver operating characteristic curves for MRS only, RDW only, and the combined model (MRS and RDW) for the prediction of CI-AKI were 0.806 (95% CI, 0.696-0.917), 0.719 (95% CI, 0.536-0.902), and 0.846 (95% CI, 0.744-0.949), respectively.
  
  
  CONCLUSIONS
  We showed the potential predictive ability of RDW, only if used with MRS, for CI-AKI in STEMI patients. Further evaluation of RDW for predicting CI-AKI in patients with STEMI is needed.
authors.affiliation: Department of Cardiology, St. Luke's International Hospital, Tokyo, Japan. Electronic address: atmizu@luke.ac.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Mizuno
authors.affiliation: Center for Clinical Epidemiology, St. Luke's Life Science Institute, Tokyo, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Ohde
authors.affiliation: Department of Cardiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nishizaki
authors.affiliation: Division of Nephrology, Department of Internal Medicine, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Komatsu
authors.affiliation: Department of Cardiology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Niwa
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D004909:Erythrocyte Indices; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging*; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D012372:ROC Curve; D011859:Radiography; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media
keywords: Bootstrapping; Contrast-induced acute kidney injury; Mehran risk score; Red blood cell distribution width; ST-elevation myocardial infarction