title: Relationship between red cell distribution width and long-term mortality in patients with non-ST elevation acute coronary syndrome.
abstract: OBJECTIVE
  Red cell distribution width (RDW) has been reported to be a predictor of cardiac events in coronary artery disease (CAD). Here, we hypothesized that RDW level on admission would be predictive of adverse outcomes in non-ST elevation acute coronary syndrome (NST-ACS).
  
  
  METHODS
  In total, 202 patients with NST-ACS (159 males and 43 females) were retrospectively analyzed. The patients were divided into two groups based on the 50th percentile of admission RDW levels. A high RDW group (n=100) was defined as those patients having RDW levels of >14.0. The relationship between RDW and primary endpoint (cardiovascular death), secondary endpoints [(reinfarction, repeat target vessel revascularization-percutaneous/surgical)], and major adverse cardiac events (MACE) were assessed. The median follow-up time was 18 (13-24) months.
  
  
  RESULTS
  The patients in the high RDW group were older (62.9 vs. 57.5, p = 0.001). Multivessel disease, low-density lipoprotein, creatinine, platelet, CK-MB, troponin I, and RDW were higher (p = 0.047, p = 0.003, p = 0.012, p = 0.012, p = 0.017, p < 0.001, respectively), and gender (male/female), ejection fraction, and hemoglobin levels were lower (p = 0.021, p = 0.04, p = 0.016, respectively) in the high RDW group. Cardiovascular death and MACE were higher in the high RDW group (16% vs. 4.9%, p = 0.01, 52% vs. 31.4%, p = 0.003, respectively). By multiple regression analysis in 202 patients, age ≥ 65 and RDW >14.0% on admission were found to be powerful independent predictors of cardiovascular mortality (OR: 4.5, 95% CI: 1.5-13.1, p = 0.005, OR: 3.0, 95% CI: 1.0-8.9, p = 0.039, respectively).
  
  
  CONCLUSIONS
  A high RDW level on admission is associated with increased long-term mortality in patients with NST-ACS.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University; Çanakkale-Turkey. adembekler27@gmail.com.
authors.forename: Adem
authors.initials: A
authors.lastname: Bekler
authors.forename: Erhan
authors.initials: E
authors.lastname: Tenekecioğlu
authors.forename: Gökhan
authors.initials: G
authors.lastname: Erbağ
authors.forename: Ahmet
authors.initials: A
authors.lastname: Temiz
authors.forename: Burak
authors.initials: B
authors.lastname: Altun
authors.forename: Ahmet
authors.initials: A
authors.lastname: Barutçu
authors.forename: Emine
authors.initials: E
authors.lastname: Gazi
authors.forename: Fahri
authors.initials: F
authors.lastname: Güneş
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yılmaz
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000401:mortality*; D004909:Erythrocyte Indices; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014421:Turkey