Red blood cell distribution width (RDW) and adverse outcomes in acute coronary syndrome patients

Abstract

Background and objectives. Red blood cell distribution width (RDW) is an early biomarker indicative of the inflammatory process. Elevated levels of systemic and local inflammation are integral to the pathophysiology of acute coronary syndromes (ACS). This study aims to examine the correlation between increased RDW and various severe prognostic factors associated with ACS. Materials and methods. This cross-sectional descriptive study was conducted on a cohort of 60 patients diagnosed with acute coronary syndromes (ACS). The diagnostic threshold for elevated RDW-CV was established at 15%. Accordingly, the study population was stratified into two groups: group 1 (RDW-CV≤15%), and group 2 (RDW-CV15%). Results. The range of RDW-CV (%) distribution is from 11.2% to 16.9%, with a mean value of 14.2±1.3. A negative correlation exists between RDW-CV (%) and ejection fraction (EF%) (r=-0.4, p<0.01). Univariate linear regression analysis indicates that a 1% increase in RDW-CV (%) corresponds to a 3.3% decrease in EF (%) (Coefficient=-3.3, p<0.01). Furthermore, univariate logistic regression analysis reveals that patients with RDW >15% have a 9.3-fold increased risk of heart failure with reduced EF (OR=9.3, p<0.01) and a 4.5-fold increased risk of having damage to 2-3 coronary vessels (OR=4.5, p<0.05) compared to those with RDW≤15%. ROC curves demonstrate that RDW has a good predictive ability for reduced EF (AUC=0.779, 95% CI 0.626-0.932, p=0.006). Conclusions. There is a significant relationship between elevated RDW and severe prognostic factors in acute coronary syndromes (ACS), including reduced ejection fraction (EF) and the extent of coronary vessel damage. Monitoring this straightforward hematological marker can enhance prognostic accuracy and inform appropriate treatment strategies.