Elevated Red Blood Cell Distribution Width Is Associated with Higher Recourse to Coronary Artery Bypass Graft

Abstract

Background: Red blood cell distribution width (RDW) is a measure of heterogeneity in erythrocyte size used in the differential diagnosis of anemia. High levels are associated with elevated cardiovascular biomarkers and increased mortality. The hypothesis of this study is that high RDW levels on admission are associated with higher recourse to coronary artery bypass graft (CABG) in unstable angina (UA) or non-ST-elevation myocardial infarction (NSTEMI) patients. Methods: An observational, cross-sectional study of all adult patients undergoing coronary angiography admitted to an urban tertiary care center in 2007 with UA or NSTEMI was conducted. Data was gathered by review of inpatient charts. RDW was considered ‘high’ if it exceeded the 95th percentile (16.3%). Results: Among the 503 subjects included in the analysis, high RDW was independently associated with higher recourse to CABG versus a nonsurgical approach [OR = 2.39 (1.04–5.50); p = 0.041] but not with conservative management [OR = 0.97 (0.51–1.84); p = 0.922] or percutaneous coronary intervention [OR = 0.67 (0.36–1.25); p = 0.208]. Conclusions: This study of patients with UA or NSTEMI demonstrated an independent association of elevated RDW with higher recourse to CABG. RDW should be considered in the stratification of patients presenting with UA or NSTEMI.