Roles of the red cell distribution width and neutrophil/lymphocyte ratio in predicting thrombolysis failure in patients with an ST-segment elevation myocardial infarction
| Autor: | Rojhat Altndağ, Bernas Altntaş, Erkan Baysal, Utkan Sevuk, Şahin Adyaman, Barş Yaylak, İlyas Kaya, Yakup Altas, Mustafa Çetin |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Erythrocyte Indices
Male medicine.medical_specialty Ticlopidine Neutrophils medicine.medical_treatment Myocardial Infarction Coronary Angiography Culprit Sensitivity and Specificity Electrocardiography Leukocyte Count Percutaneous Coronary Intervention Fibrinolytic Agents Internal medicine medicine Humans Thrombolytic Therapy Myocardial infarction Lymphocyte Count Treatment Failure Aged Retrospective Studies Salvage Therapy Aspirin business.industry Percutaneous coronary intervention Red blood cell distribution width Hematology General Medicine Thrombolysis Middle Aged medicine.disease Clopidogrel Prognosis ROC Curve Tissue Plasminogen Activator Conventional PCI Cardiology Tenecteplase Drug Therapy Combination Female business Fibrinolytic agent medicine.drug |
| Zdroj: | Blood coagulationfibrinolysis : an international journal in haemostasis and thrombosis. 26(3) |
| ISSN: | 1473-5733 |
| Popis: | Red cell distribution width (RDW) and the neutrophil/lymphocyte ratio (NLR) are predictors of cardiovascular risk that have been shown to correlate with impaired reperfusion and increased morbidity and mortality in patients with an ST-segment elevation myocardial infarction (STEMI). We hypothesized that RDW and the NLR would be associated with failed thrombolysis. One hundred and two STEMI patients were included in the study; 32 had failed thrombolysis while the other 70 fulfilled the criteria for successful thrombolysis. Thrombolysis failure was defined as a need for rescue percutaneous coronary intervention (PCI), in-hospital mortality, unplanned PCI during hospitalization or complete occlusion of the culprit coronary artery on follow-up angiography. RDWs were compared between patients with failed or successful thrombolysis. There were no significant differences in the demographic or clinical baseline characteristics of the two groups. The mean RDW was significantly higher in the failed thrombolysis group than in the successful thrombolysis group (P = 0.028). The cutoff RDW value for failed thrombolysis was more than 14.3 fl with a sensitivity of 90.6% and a specificity of 61.4% (area under the curve, 0.774; 95% confidence interval, 0.680-0.851; P < 0.001) on receiver operating characteristics curve analysis. In addition, the prevalence of failed thrombolysis was significantly higher in patients with an RDW more than 14.3 fl than in those with an RDW of 14.3 fl or less (51.8 and 6.5%, respectively, P < 0.001 by multivariate analysis). The NLR was significantly higher in patients with an RDW more than 14.3 fl than in those with an RDW 14.3 fl or less (4 ± 2.5 and 2.8 ± 1.5, respectively, P = 0.007). RDW and the NLR may be used as adjunctive readily available factors for assessment of thrombolysis outcome upon admission. |
| Databáze: | OpenAIRE |
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