The Study On The Factors Related To The Distribution Of Red Blood Cells And Related Factors Of Short-term Prognosis In Patients With Acute Myocardial Infarction Treated By PCI

Objective:To explore RDW increase-related factors in ST segment elevation myocardial infarction(STEMI)patients with percutaneous coronary intervention(PCI)treatment,as well as the associated between RDW and the short-term prognosis of STEMI patients with PCI treatment.Methods:1.A total of 424 patients with STEMI treated with PCI were divided into Q1(RDW≦12.4%,n= 104),Q2(12.4%<RDW≦13%,n=113),Q3(13%<RDW≦13.9,n = 121),and Q4(13.9%<RDW,n = 85)groups according to the RDW level determined before PCI.General data and past medical history of these patients were collected.The number of white blood cell(WBC),number of granulocytes(GR),hemoglobin(Hb),platelet(PLT),and mean platelet volume(MPV)were recorded before PCI.And so is the platelet distribution width(PDW),coronary artery lesions in PCI and Gensini score,serum N-terminal pro-brain natriuretic peptide(NTpro-BNP),high-sensitivity C-reactive protein(hs-CRP),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),cholesterol(TG),left ventricular ejection fraction(LVEF)levels.SPSS 19.0 software was employed to analyze the data,including comparing the clinical basic data and in-hospital outcomes of the four groups,and use the ordered multiple logistic regression analysis to analyze the difference(P<0.05)among the four groups of patients and the increase of RDW.We further analyzed RDW increase-associated risk factors.2.According to 424 patients with STEMI who underwent PCI,major adverse cardiac events(MACE)were divided into positive group(n=78)and negative group(n=346).Data such as previous medical history,WBC,GR,RDW,Hb,PLT,MPV,PDW in patients before PCI,coronary artery lesions in PCI and Gensini score,NTpro-BNP,hs-CRP,TC,HDL-C,LDL-C,TG,LVEF,were collected.Data were analyzed using SPSS 19.0 software,and the clinical data were compared between the two groups.The single factor and multivariate logistic regression analysis were used to analyze the correlation between the two groups(P<0.05)and MACE.We also explored the relationship between RDW and short-term prognosis in patients with STEMI.Results:1.The difference of dyslipidemia(37.72%,35.78%,39.66%,21.18%,P=0.019),WBC(10.13±3.50,10.28±3.01,10.89±3.27,11.38±3.52,P=0.026),MPV(8.79±0.96,8.89 ± 0.88,9.05 ± 1.08,9.74 ± 1.14,P<0.001),TC(4.83 ± 1.03,4.87 ± 1.00,4.92 ± 1.05,4.60 ± 0.94,P=0.026),LDL-C(2.70 ± 0.68,2.85 ± 0.71,2.85 ± 0.67,2.55±0.67,P=0.006),Lg NTpro-BNP(2.43±0.16,2.44±0.18,2.51±0.19,2.79±0.12,P<0.001),hs-CRP(4.04±1.52,4.46± 1.61,5.14±2.63,5.60±2.06,P<0.001),was reported to be statistically significant(P<0.05).There was significant difference in the number of coronary lesions between the four groups(P<0.05).The incidence of multivessel disease(28.07%,29.36%,39.66%,48.24%,P<0.001)increased obviously with the increase of RDW.The patient’s Gensini score(26.58±9.52,33.59± 13.19,42.66 ± 15.88,65.13 ±23.63,P<0.001)increased with the increase of RDW,and the difference was statistically significant(P<0.05).With the multivariate logistic regression analysis,we found that MPV(OR=1.010,P=0.015),NTpro-BNP(OR=1.008,P<0.001),hs-CRP(OR=0.707,P<0.001),Gensini score(OR=1.106,P<0.001)was statistically significant(P<0.05),which was a risk factor for RDW elevation.2.Patients of the MACE-positive group had angina(46.2%vs.32.4%,P=0.021),WBC(11.59±3.42 vs.10.41±3.30,P=0.005),and MPV(9.78±1.23 vs.8.92±0.957,P<0.001),RDW(13.85 ± 1.45 vs.13.155±1.10,P<0.001),NTpro-BNP(496.91±266.05 vs.356.68± 178.02,P<0.001),hs-CRP(6.15 ± 3.01 vs.4.47 ± 1.68,P<0.001),single coronary artery(26.92%vs.41.91%,P=0.001),double(12.82%vs.28.03%,P=0.001),multiple(60.26%vs.30.06%,P<0.001).The incidence of lesions and Gensini score(55.51 ± 23.11 vs.37.14± 16.78,P<0.001)were statistically significant in MACE-positive group(P<0.05).Univariate logistic regression analysis showed that RDW(B=0.375,P<0.001),hs-CRP(B=0.194,P<0.001),MPV(B = 0.506,P<0.001),NTpro-BNP(B=0.002,P<0.001),Gensini score(B=0.037,P<0.001)were statistically significant.Results of multivariate logistic regression analysis showed that,within these factors,RDW(B = 0.409,P =0.022)and Gensini score(B=0.047,P<0.001)were statistically significant(P<0.05).Among them,RDW(OR=1.505,95%CI:1.066-2.125)was a risk factor for MACE during hospitalization.Conclusion:1.RDW elevation was associated with MPV,NTpro-BNP,hs-CRP,and Gensini scores.2.RDW is associated with the extent of coronary lesions in patients.3.RDW is associated with short-term prognosis in patients with STEMI treated with PCI and is a relevant factor for MACE.