title: The impact of admission red cell distribution width on long-term cardiovascular events after primary percutaneous intervention: A four-year prospective study.
abstract: BACKGROUND
  Red cell distribution width (RDW) is an indicator of erythrocyte in different size, and its prognostic value has been demonstrated in numerous cardiac and non-cardiac diseases. The purpose of this study was to evaluate the predictive value of RDW on the long- -term cardiovascular events in patients undergoing primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  Ninety-six consecutive patients (mean age 60.6 ± 12.5 years, 77.1% male) with ST-segment elevation myocardial infarction (STEMI), who were treated with primary PCI, were analyzed prospectively. Baseline RDW and high sensitive C-reactive protein (hs-CRP) were measured. The patients were followed up for major adverse cardiac events (MACE) for up to 48 months after discharge.
  
  
  RESULTS
  There were 30 patients with long-term MACE (Group 1) and 66 patients without long-term MACE (Group 2). Age, admission RDW, hs-CRP and creatine kinase-MB levels, heart rate after PCI, previously used angiotensin converting enzyme inhibitor, left anterior descending artery lesion, and electrocardiographic no-reflow were higher in Group 1. Admission hemoglobin levels were lower in Group 1. An RDW level ≥ 13.85% measured on admission had 80% sensitivity and 64% specificity in predicting long-term MACE on receiver-operating characteristic curve analysis. In multivariate analyses, only admission RDW (HR 5.26, < 95% CI 1.71-16.10; p = 0.004) was an independent predictor of long-term MACE.
  
  
  CONCLUSIONS
  A high baseline RDW value in patients with STEMI undergoing primary PCI is independently associated with increased risk for long term MACE.
authors.affiliation: Department of Cardiology, Balikesir University, School of Medicine, Balikesir, Turkey. isikturgay@yahoo.com.
authors.forename: Turgay
authors.initials: T
authors.lastname: Isik
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kurt
authors.forename: Ibrahim Halil
authors.initials: IH
authors.lastname: Tanboga
authors.forename: Erkan
authors.initials: E
authors.lastname: Ayhan
authors.forename: Zeki Yuksel
authors.initials: ZY
authors.lastname: Gunaydin
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kaya
authors.forename: Huseyin
authors.initials: H
authors.lastname: Uyarel
mesh_terms: D017023:Coronary Angiography; D004562:Electrocardiography; D004909:Erythrocyte Indices; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D000072657:ST Elevation Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors
keywords: ST-segment elevation myocardial infarction; long-term prognosis; red cell distribution width