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Clin Cardiol. 2013 Jun;36(6):336-41. doi: 10.1002/clc.22114. Epub 2013 Apr 8.

Incremental predictive value of red cell distribution width for 12-month clinical outcome after acute myocardial infarction.

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  • 1Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.

Abstract

BACKGROUND:

The incremental predictive value of red cell distribution width (RDW) for major adverse cardiac events (MACEs) has not been fully investigated in patients with acute myocardial infarction (AMI).

HYPOTHESIS:

The aim of this study was to determine the incremental value of RDW to the established risk factors in predicting clinical outcomes after AMI.

METHODS:

Between November 2005 and January 2010, 1596 patients with AMI (1070 male; mean age, 64.5 ± 11.9 years) were analyzed in this study. Baseline levels of RDW were measured at the time of admission. The 12-month MACEs were defined as death and nonfatal MI.

RESULTS:

The RDW levels were significantly higher in patients with 12-month MACEs (13.8 ± 1.3% vs 13.3 ± 1.2%, P < 0.001). In a Cox proportional hazards model, RDW (hazard ratio [HR]: 1.19, P = 0.016) was an independent predictor for 12-month MACEs. Adding RDW to established risk factors and hemoglobin levels significantly improved prediction for 12-month MACEs, as shown by the net reclassification improvement (0.297; P = 0.012) and integrated discrimination improvement (0.0143; P = 0.042). The likelihood ratio test showed that RDW added incremental predictive value to the combination of hemoglobin and established risk factors (P = 0.005). Patients were categorized into 4 groups according to quartiles of RDW at baseline. Adjusted HRs for 12-month MACEs were 1 (RDW ≤12.6%, reference), 4.24 (RDW 12.7%-13.1%, P = 0.01), 4.36 (RDW 13.2%-13.9%, P = 0.008), and 6.18 (RDW 13.2%-13.9%, P = 0.001), respectively.

CONCLUSIONS:

In post-myocardial infarction patients, baseline RDW levels at admission could provide incremental predictive value to established risk factors for predicting 12-month MACEs.

© 2013 Wiley Periodicals, Inc.

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PMID:
23568781
[PubMed - indexed for MEDLINE]
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