Dados do Trabalho

Título

Long-term pattern of red cell distribution width in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

Fundamentação/Introdução

Red cell distribution width (RDW) is an indirect marker of inflammation and an independent predictor of long-term mortality.

Objetivos

The aim of this study was to determine RDW values in patients with ST-elevation acute myocardial infarction (STEMI) submitted to primary percutaneous coronary intervention (PCI) and evaluate its association with adverse outcomes.

Delineamento e Métodos

We measured RDW in STEMI patients before undergoing primary PCI and divided into low and high RDW. Patients were followed-up to 3 years after their discharge for the occurrence of in-hospital, 30-days and long-term major adverse cardiovascular events (MACE) and mortality.

Resultados

We included 485 patients with mean age of 61.1(±12.5) years, 62.9% were male. In multivariate analysis, RDW remained independent predictor of long-term mortality and MACE (relative risk[RR]=1.40;95% confidence interval[95%CI]=1.05-1.87;p=0.01 and RR=1.42; 95%CI=1.13-1.84; p=0.004). Area under the curve for long-term mortality was 0.65(95%CI=0.61-0.69;p<0.0001). RDW<13.4 had a negative predictive value of 87.4% for all cause mortality. Patients who had worse outcomes remained with higher values of RDW during the follow-up.

Conclusões/Considerações finais

High RDW is an independent predictor of long-term mortality in patients with STEMI undergoing primary PCI. A low RDW have an excellent negative predictive value for long-term mortality. Patients with sustained elevated levels of RDW have worse outcomes at long term follow-up.

Palavras-chave

Myocardial infarction; percutaneous coronary intervention; biomarkers; red cell distribution width

Área

Clínica Médica