Background: The identification of patients at higher risk of developing percutaneous transluminal angioplasty (PTA)-related complications is pivotal for achieving better clinical outcomes. We carried out a single-center, observational, retrospective study to explore whether in-hospital changes of red blood cell distribution width (RDW) may help predicting early development of PTA-related complications.
Methods: The study population consisted of all consecutive patients who underwent PTA for severe peripheral artery occlusive disease (PAOD) during a 2-year period. RDW was measured at hospital admission and discharge, and the delta was calculated. Patient follow-up was routinely performed 1-month after hospital discharge, and was based on thoughtful medical assessment and arterial ultrasonography. The control population consisted of 352 ostensibly healthy subjects.
Results: The final PTA group consisted of 224 patients. Hemoglobin was lower, whilst mean corpuscular volume (MCV) and RDW were higher in PAOD cases than in controls. Overall, 11 PAOD patients (4.9%) developed clinically significant PTA-related complications 1-month after hospital discharge. Patients who developed 1-month PTA-related complications had lower hemoglobin concentration, but higher RDW and delta RDW than those who did not. Patients with delta RDW >1 had 60% higher risk of developing 1-month PTA-related complications and 88% higher risk of developing early reocclusion. Overall, RDW exhibited an area under the curve (AUC) of 0.68 and 0.74 for predicting 1-month PTA-related complications and early reocclusion, respectively.
Conclusions: The results of this study suggest that RDW may play a role for guiding the clinical decision making of PTA patients immediately after hospital discharge.
Uvod: Identifikacija pacijenta sa povećanim rizikom od razvoja perkutane transluminalne angioplastije (PTS)-pove zane sa komplikacijama je u osnovi za postizanje boljeg kliničkog ishoda. Izvođena je jedno-centrična, opservaciona, retrospektivna studija kako bi se istražilo da li u hospitalnim uslovima promene širine distribucije eritrocita (RDW) mogu pomoći predviđanju ranog razvoja PTA-povezanih komplikacija. oštećenja (ADHF).
Metode: Ispitivana grupa se sastojala od pacijenata koji su imali PTA usled teškog perifernog okluzivnog oboljenja (PAOD) u toku dvogodišnjeg perioda. RDW je meren pri prijemu u bolnicu i nakon otpuštanja, nakon čega je izračunata delta vrednost. Pacijenti su rutinski praćeni mesec dana nakon otpuštanja iz bolnice, medicinski procenjivani i urađena im je arterijska ultrasonografija. Kontrolna grupa se sastojala od 352 zdrave osobe.
Rezultati: Krajnja PTA grupa imala je 224 pacijenta. Hemoglobin je bio snižen, dok su MCV i RDW bili viši u slučaju PAOD u odnosu na kontrolnu grupu. Ukupno gledajući, 11 PAOD pacijenata (4,9%) razvilo je kliničke znake značajnih PTA komplikacija 1 mesec nakon otpuštanja iz bolnice. Ovi pacijenti su imali snižene koncentracije hemoglobina, povišene vrednosti RDW i delta RDW u odnosu na one koji to nisu imali. Pacijenti sa delta RDW > 1 imali su 60% viši rizik za razvoj jednomesečnih komplikacija i 88% veći rizik zarazvoj okluzije. Ukupno gledajući, RDW je imala površinu ispod krive (AUC) 0,68 i 0,74 za predviđanje 1-mesečnih PTA-srodnih komplikacija, odnosno za ranu reokluziju.
Zaključak: Rezultati ovog izučavanja ukazuju da RDW može imati značaj za donošenje kliničke odluke da se PTA pacijenti prate odmah nakon otpuštanja iz bolnice.
Keywords: complications; percutaneous transluminal angioplasty; peripheral artery occlusive disease; red blood cell distribution width; restenosis.