The Relationship between Red Cell Distribution Width and Residual SYNTAX Scores in ST-Segment Elevation Myocardial Infarction Patients after Percutaneous Coronary Intervention.

Yang Ling,Cong Fu,Shengxing Tang,Wei Wang,Qun Fan,Jichun Liu,Benoit Dugue

doi:10.1155/2021/3281837

Abstract

Objective Residual SYNTAX score (rSS) values have been suggested to serve as an independent predictor of mortality in ST-segment elevation myocardial infarction (STEMI) patients following percutaneous coronary intervention (PCI). Prior work has also indicated that red cell distribution width (RDW) can predict the incidence of major adverse cardiac events (MACEs) in STEMI patients. As such, we sought to explore the relationship between RDW and rSS in STEMI patients that have undergone PCI. Methods In total, 456 eligible patients were recruited for this study. Youden's index was used to calculate the optimal RDW cut-off value, after which the relationship between RDW and rSS values was assessed through Spearman's correlation analyses. Independent predictors of high rSS levels were then identified via multivariate logistic regression analysis. Results Patients were separated into two groups based upon whether they exhibited high RDW levels (>13.9, Group 1) or low RDW levels (<13.9, Group 2). The average rSS value of patients in Group 2 was found to be significantly decreased compared to patients in Group 1 (P < 0.001). RDW values were found to be positively correlated with rSS (r = 0.604, P < 0.001), and multivariate logistic regression analysis determined that high RDW levels were independently predictive of higher rSS (OR = 27.1 [14.8-51.7]; P < 0.001). Additionally, a nomogram incorporating RDW exhibited good calibration, discriminative capacity, and clinical utility. Conclusions In summary, RDW is strongly correlated with rSS in STEMI patients following PCI, with high RDW levels serving as an independent predictor of high rSS in this patient population.

Highlights

ST-segment elevation myocardial infarction (STEMI), known as transmural myocardial ischemia, is still the most prominent cause of global morbidity and mortality [1,2,3]
456 STEMI patients that had undergone percutaneous coronary intervention (PCI) were included in our retrospective analysis
There were no significant differences in gender, smoking, hypertension, diabetes mellitus, hemoglobin, LMO, MO, EO, glucose, total cholesterol (TC), TG, high-density lipoprotein cholesterol (HDL-c), lowdensity lipoprotein cholesterol (LDL-c), apoB, apoA1, lipoprotein a (Lpa), or uric acid levels between these groups

Summary

Introduction

ST-segment elevation myocardial infarction (STEMI), known as transmural myocardial ischemia, is still the most prominent cause of global morbidity and mortality [1,2,3]. Over 40% of STEMI patients undergoing PCI exhibit multivessel coronary artery disease (MVD) [5, 6], and the incidence of MVD among these patients is positively correlated with higher major adverse cardiac event (MACE) rates and allcause mortality as compared to STEMI patients with single-vessel disease (SVD) [7, 8]. Residual coronary stenoses following PCI have the potential to be extremely detrimental in patients with STEMI and MVD. Among individuals with moderate- and highrisk acute coronary syndrome (ACS), an rSS > 8 is closely linked to poorer patient outcomes including higher rates of 1-year mortality and MACEs [9]. RSS has been shown to independently predict MACE incidence and allcause mortality in STEMI patients [5, 10]

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Results

Conclusion