Red cell distribution width is a predictor of ST resolution and clinical outcome following thrombolysis in acute ST elevation myocardial infarction
| Autor: | Nariman Sepehrvand, Leili Faridi, Nader D. Nader, Naser Aslanabadi, Samad Ghaffari, Nayyer Masoumi, Arezou Tajlil, Leili Pourafkari |
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| Rok vydání: | 2015 |
| Předmět: |
Erythrocyte Indices
Male medicine.medical_specialty Erythrocytes medicine.medical_treatment 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Fibrinolytic Agents Internal medicine medicine Clinical endpoint ST segment Humans Thrombolytic Therapy 030212 general & internal medicine Myocardial infarction Aged business.industry Red blood cell distribution width Hematology Thrombolysis Middle Aged medicine.disease Prognosis Treatment Outcome Heart failure Cardiology ST Elevation Myocardial Infarction Female business Fibrinolytic agent Mace |
| Zdroj: | Thrombosis research. 140 |
| ISSN: | 1879-2472 |
| Popis: | Introduction 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 24 h, 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. Conclusion 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. |
| Databáze: | OpenAIRE |
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