title: Red cell distribution width is a predictor of ST resolution and clinical outcome following thrombolysis in acute ST elevation myocardial infarction.
abstract: BACKGROUND
  Red cell distribution width (RDW) has been shown to associate with adverse outcomes in various cardiovascular diseases. We aimed to explore the predictive value of RDW for resolution of the ST segment (STR) after thrombolytic therapy in patients with ST elevation myocardial infarction (STEMI).
  
  
  METHODS
  Patients with STEMI with indication for thrombolytic therapy were recruited from a university center between 2013 and 2015. A comprehensive laboratory investigation at the time of admission included measurement of RDW. Following thrombolysis ST segment resolution was assessed after 90 min. A positive response (STR ≥ 50%) was the primary endpoint. Secondary endpoints were major adverse cardiac events (MACE) defined as occurrence of acute heart failure, ventricular dysrhythmia beyond the first 24h, cardiac arrest or death during hospitalization.
  
  
  RESULTS
  A total of 312 patients (271 male) with the mean age of 57.9 ± 12.3 were enrolled. RDW on admission was 14.1 ± 1.0% (range: 11.6-17.7%). STR was seen in 191 cases (61.2%). MACE occurred in 36 (11.5%) patients. The long-term mortality rate was 7.1% during the follow-up period of 7.7 ± 3.2 months. Even after adjusting for co-morbid conditions, in multivariate model, baseline RDW, independently predicts STR (RR=2.46, 95% CI 1.32-4.57, P=0.005) and in hospital occurrence of MACE (RR=3.17, 95% CI 1.23-8.46, p=0.017). The cut-off values for RDW in predicting STR and MACE were 14.2% and 14.4%, respectively.
  
  
  CONCLUSIONS
  An elevated baseline RDW could predict adverse outcomes and response to thrombolytic therapy in patients with STEMI. This extends our knowledge about RDW value in prognostication.
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: ghafaris@gmail.com.
authors.forename: Samad
authors.initials: S
authors.lastname: Ghaffari
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Anesthesiology, University at Buffalo, Buffalo, NY, United States. Electronic address: leilipou@buffalo.edu.
authors.forename: Leili
authors.initials: L
authors.lastname: Pourafkari
authors.affiliation: Mazankowski Alberta Heart Institute, University of Alberta, Canada. Electronic address: nariman256@gmail.com.
authors.forename: Nariman
authors.initials: N
authors.lastname: Sepehrvand
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: aslan@gmail.com.
authors.forename: Naser
authors.initials: N
authors.lastname: Aslanabadi
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: lfaridi@gmail.com.
authors.forename: Leili
authors.initials: L
authors.lastname: Faridi
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: arezou.tajlil@gmail.com.
authors.forename: Arezou
authors.initials: A
authors.lastname: Tajlil
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: nmasoumi@gmail.com.
authors.forename: Nayyer
authors.initials: N
authors.lastname: Masoumi
authors.affiliation: Department of Anesthesiology, University at Buffalo, Buffalo, NY, United States. Electronic address: nnader@buffalo.edu.
authors.forename: Nader D
authors.initials: ND
authors.lastname: Nader
mesh_terms: D000368:Aged; D004909:Erythrocyte Indices / Q000187:drug effects*; D004912:Erythrocytes / Q000187:drug effects / Q000473:pathology; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents
keywords: Myocardial Infarction; Red Cell Distribution Width; ST Resolution and Thrombolysis