title: Combined Value of Red Blood Cell Distribution Width and Global Registry of Acute Coronary Events Risk Score for Predicting Cardiovascular Events in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.
abstract: Global Registry of Acute Coronary Events (GRACE) risk score and red blood cell distribution width (RDW) content can both independently predict major adverse cardiac events (MACEs) in patients with acute coronary syndrome (ACS). We investigated the combined predictive value of RDW and GRACE risk score for cardiovascular events in patients with ACS undergoing percutaneous coronary intervention (PCI) for the first time. We enrolled 480 ACS patients. During a median follow-up time of 37.2 months, 70 (14.58%) patients experienced MACEs. Patients were divided into tertiles according to the baseline RDW content (11.30-12.90, 13.00-13.50, 13.60-16.40). GRACE score was positively correlated with RDW content. Multivariate Cox analysis showed that both GRACE score and RDW content were independent predictors of MACEs (hazard ratio 1.039; 95% confidence interval [CI] 1.024-1.055; p < 0.001; 1.699; 1.294-2.232; p < 0.001; respectively). Furthermore, Kaplan-Meier analysis demonstrated that the risk of MACEs increased with increasing RDW content (p < 0.001). For GRACE score alone, the area under the receiver operating characteristic (ROC) curve for MACEs was 0.749 (95% CI: 0.707-0.787). The area under the ROC curve for MACEs increased to 0.805 (0.766-0.839, p = 0.034) after adding RDW content. The incremental predictive value of combining RDW content and GRACE risk score was significantly improved, also shown by the net reclassification improvement (NRI = 0.352, p < 0.001) and integrated discrimination improvement (IDI = 0.023, p = 0.002). Combining the predictive value of RDW and GRACE risk score yielded a more accurate predictive value for long-term cardiovascular events in ACS patients who underwent PCI as compared to each measure alone.
authors.affiliation: Department of Cardiovascular Medicine, Shaanxi Province People's Hospital, Xi'an, Shaanxi, China.
authors.forename: Na
authors.initials: N
authors.lastname: Zhao
authors.affiliation: Department of Medical Affairs, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Mi
authors.affiliation: Department of Cardiovascular Medicine, Shaanxi Province People's Hospital, Xi'an, Shaanxi, China; Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Cardiovascular Medicine, Shaanxi Province People's Hospital, Xi'an, Shaanxi, China.
authors.forename: Shuo
authors.initials: S
authors.lastname: Pan
authors.affiliation: Department of Cardiovascular Medicine, Shaanxi Province People's Hospital, Xi'an, Shaanxi, China.
authors.forename: Jiaojiao
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Cardiovascular Medicine, Shaanxi Province People's Hospital, Xi'an, Shaanxi, China.
authors.forename: Dongyu
authors.initials: D
authors.lastname: Xia
authors.affiliation: Department of Cardiovascular Medicine, Shaanxi Province People's Hospital, Xi'an, Shaanxi, China.
authors.forename: Zhongwei
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Cardiovascular Medicine, Shaanxi Province People's Hospital, Xi'an, Shaanxi, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Cardiovascular Medicine, Shaanxi Province People's Hospital, Xi'an, Shaanxi, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Xiang
authors.affiliation: Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
authors.forename: Zuyi
authors.initials: Z
authors.lastname: Yuan
authors.affiliation: Department of Cardiovascular Medicine, Shaanxi Province People's Hospital, Xi'an, Shaanxi, China.
authors.forename: Gongchang
authors.initials: G
authors.lastname: Guan
authors.affiliation: Department of Cardiovascular Medicine, Shaanxi Province People's Hospital, Xi'an, Shaanxi, China.
authors.forename: Junkui
authors.initials: J
authors.lastname: Wang
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D000368:Aged; D016002:Discriminant Analysis; D004909:Erythrocyte Indices; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors