The impact of red blood cell distribution width on outcome of elective percutaneous coronary intervention in non-anemia patients

Abstract

Objective: Previous studies have revealed that the red blood cell distribution width (RDW) was associated with long-term prognosis in patients undergoing percutaneous coronary intervention (PCI). However, they did not exclude patients with anemia. This study, thus, investigated the association between RDW and prognosis in non-anemia patients. Methods: A total of 2 732 patients underwent elective PCI from July 2009 to September 2011 were enrolled in the study. These patients were divided into two groups based on their baseline median RDW levels: low RDW group (RDW<12.1%) and high RDW group (RDW≥12.1%). All the subjects were followed up for an average period of 18 months and the associations between baseline RDW levels and postoperative mortality were analyzed. Results: Patients in the high RDW group were elder and had more women than those in low RDW group. Most of them had prior history of hypertension, stroke, myocardial infarction, but few of them were current smokers. Subjects in the high RDW group had higher systolic blood pressure and total cholesterol levels, and lower erythrocyte mean corpuscular volume, hemoglobin level, estimated glomerular filtration rate level, and left ventricular ejection fraction. Moreover, more subjects in the high RDW group were combined with left main, ostial and chronic total occlusion lesion, and had a lower complete revascularization rate. The postoperative mortality was significantly higher in the high RDW group than that in the low RDW group (2.4% vs 0.6%, P<0.001). Multivariate Cox regression analysis revealed that preoperative high RDW level was an independent risk factor for postoperative mortality after adjustment of other factors (HR 3.930, 95%CI 1.600-9.656, P=0.003). Conclusion: High RDW might be a marker for the postoperative mortality in non-anemic patients undergoing elective PCI.