[Impact of red blood cell distribution width on risk for bleeding events in patients with non-ST elevation acute coronary syndromes]. / Implicações do índice de dispersão eritrocitária no risco de eventos hemorrágicos em doentes com síndrome coronária aguda sem supradesnivelamento do segmento ST.

INTRODUCTION: Higher values of red blood cell distribution width (RDW) have recently been associated with worse outcome in patients with cardiovascular disease. However, its relation to bleeding events in patients with non-ST elevation acute coronary syndromes has not been established. AIM: To determine the prognostic value of RDW in patients with non-ST segment elevation acute coronary syndromes, particularly regarding the risk of major bleeding. METHODS: We analyzed 513 consecutive patients admitted with non-ST elevation acute coronary syndromes. The population was divided into tertiles of baseline RDW and clinical, laboratory characteristics and adverse events were analyzed for each group. The primary outcome was defined as the occurrence of major bleeding (according to the Crusade bleeding score). The predictive value of RDW for risk of major bleeding was determined. RESULTS: The mean RDW was 15.13%±1.62%. Patients in the third tertile were older and more frequently had renal dysfunction or previous coronary revascularization. Higher values of RDW were associated with greater risk of major bleeding and in-hospital death. RDW >15.7% was an independent predictor of bleeding events (odds ratio 3.1, 95% CI 1.4-6.9). CONCLUSIONS: In a population of patients with non-ST elevation acute coronary syndromes, RDW was associated with higher in-hospital mortality and was an independent predictor of in-hospital major bleeding.