Predictive value of red cell distribution width in intrahospital mortality and postintervention thrombolysis in myocardial infarction flow in patients with acute anterior myocardial infarction.

ABSTRACT

OBJECTIVES: Recent studies have reported a strong independent association between increased red cell distribution width (RDW) and the risk of adverse outcomes in patients with heart failure, stable coronary disease, and acute coronary syndromes. However, in this study we aimed to determine the impact of an elevated RDW level on the postinterventional thrombolysis in myocardial infarction (TIMI) flow and intrahospital mortality in patients with acute anterior myocardial infarction (AMI). METHODS: A total of 763 patients with acute AMI undergoing a primary percutaneous coronary intervention were evaluated retrospectively. Upon admission, the RDW level was measured by an automated complete blood count. Postinterventional TIMI flow and intrahospital mortality was documented for all patients from hospital registries. The patients were classified according to the RDW level. RDW more than 14.8% was defined as elevated RDW. All groups were compared statistically according to the preinterventional characteristics. RESULTS: Elevated RDW was found to be an independent predictor of increased intrahospital mortality in multivariate regression analysis (hazard ratio 3.677, 95% confidence interval 1.228-11.008, P=0.02). Other independent predictors for intrahospital mortality were diabetes mellitus (hazard ratio 6.743, 95% confidence interval 1.941-23.420, P=0.003), smoking (hazard ratio 6.779, 95% confidence interval 1.505-30.534, P=0.013), and creatinine more than 0.8 mg/dl (hazard ratio 7.982, 95% confidence interval 1.759-36.211, P=0.007). However, there were no independent predictors for TIMI including elevated RDW. CONCLUSION: A high admission RDW level in patients with acute AMI undergoing a primary percutaneous coronary intervention was associated with an increased risk for intrahospital cardiovascular mortality, but was not associated with worse postinterventional TIMI flow.