Combined value of red blood cell distribution width and global registry of acute coronary events risk score on predicting long-term major adverse cardiac events in STEMI patients undergoing primary PCI

Abstract

The combined value of RDW and GRACE risk score for cardiovascular prognosis in ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) has not been fully investigated. This study was designed to explore the combined value of RDW and GRACE risk score on predicting long-term major adverse cardiac event (Mace) in STEMI patients undergoing primary PCI. This study included 390 STEMI patients. The primary endpoint at the (33.5 ± 7.1) months follow-up was composed of cardiac death and nonfatal myocardial infarction. The relationship between clinical parameters and clinical outcomes was evaluated using Cox regression model and receiver operating characteristic (ROC) analysis. Mace occurred in 126 (32.3%) patients including 54 (13.8%) cardiac deaths and 72 (18.5%) nonfatal myocardial infarctions. Patients in Mace group had significantly higher RDW and GRACE score than the patients in non-Mace group. According to the Cox model, RDW and GRACE score were the most important independent predictors of Mace and cardiac death. The best cut-off value for RDW to predict the occurrence of primary events was 13.25% (AUC = 0.694, 95% CI:0.639–0.750, P < 0.001) and that for GRACE score was 119.5 (AUC = 0.721, 95% CI:0.666–0.777, P < 0.001). The combination of RDW and GRACE score were more valuable (AUC = 0.775, 95% CI: 0.727–0.824, P < 0.001). Kaplan–Meier analysis provided significant prognostic information with the highest risk for cardiac death (Log-Rank χ2 = 24.684, P < 0.001) in group with both high RDW (> 13.25%) and high GRACE score (> 119.5). The combination of RDW level and GRACE score may be valuable and simple independent predictors of Mace and cardiac death in STEMI patients undergoing primary PCI. They may be useful tools for risk stratification and may indicate long-term clinical outcomes.

Red cell distribution width as a predictor multiple organ dysfunction syndrome in patients undergoing heart valve surgery

“…The available literature report that RDW is a predictor of mortality in patients with acute pancreatitis, septic shock and acute ischemic stroke, as well as a poor stem cell mobilization in patients with advanced chronic heart failure ( Şenol et al, 2013 ; Kim et al, 2015 ; Ani and Ovbiagele, 2009 ; Poglajen et al, 2015 ). It also showed a significant correlation between scoring system such as Glasgow coma scale (GCS), global registry of acute coronary events risk score (GRACE) and the values of the RDW ( Kara et al, 2015 , Chang et al, 2018 ).…”

Value of Hematological and Coagulation Parameters as Prognostic Factors in Acute Coronary Syndromes

“…Anisocytosis is an important predictor of severity of coronary artery disease in patients with acute MI [ 6 , 21 ]. Inflammation cause changes in erythrocyte maturation with the release in circulation of immature erythrocyte and adrenergic activation in ACS can influence erythropoiesis [ 6 ].…”

Inflammatory and Hematological Indices as Simple, Practical Severity Predictors of Microdysfunction Following Coronary Intervention: A Systematic Review and Meta-Analysis

“…8 Red blood cell distribution width (RDW) combined with GRACE (the Global Registry of Acute Cardiac Events) score could independently predict long-term MACEs in patients with STEMI undergoing pPCI. 9 Admission platelet distribution width (PDW) and mean platelet volume (MPV) are independent correlates of no-reflow and in-hospital MACEs among patients with STEMI undergoing pPCI. 10 Besides, the preprocedural MPV 11 may be independent predictors of long-term adverse outcomes in patients receiving PCI.…”