Predictive Value Of Red Cell Volume Distribution Width Standard Difference On Ischemic Events After Percutaneous Coronary Intervention In Anemia Patients

Objective: Red cell volume distribution width standard difference(RDW-SD)is seen as a proxy for heterogeneity of red blood cell volume.RDW-SD was often used for the differential diagnosis of anaemias.RDW-SD is seen as a proxy for heterogeneity of red blood cell volume.RDW-SD was often used for the differential diagnosis of anaemias.In past decades,RDW-SD plays an important role in cardiovascular system.In the present study,we investigate the predictive value of RDW-SD on ischemic events after percutaneous coronary intervention in anemia patients.Methods: Six hundred anemia patients undergoing percutaneous coronary intervention were analyzed retrospectively from 2016 to 2018.The follow-up time was two years.The primary endpoint was defined as cumulative ischemic events including all non-hemorrhagic death,myocardial infarction,all revascularization and ischemic stroke.By the cut-off value of RDW-SD,patients were divided into 2 groups:Low-RDW-SD group and High-RDW-SD group.The survival rate was calculated by the Kaplan-Meier method.A method of propensity score matching was used to adjust the effects of confounding factors on ischemic events.Finally,the risk score was calculated by establishing forecast model to evaluate the predictive value of RDW-SD on 2-year ischemic events.Results: The area of Receiver Operating Characteristic(ROC)curve was 0.602,95%CI(0.529,0.674),the sensitivity was 62.3%,and the specificity was 60.0% if RDW-SD was served as standard.The anemia patients with43.55 fl as cutoff value were divided into 2 groups.The median survival time patients in High-RDW-SD group(255 patients)is 22.07 months(95%CI:21.43-22.72),while time of Low-RDW-SD group(345 patients)is 22.89 months(95%CI:22.43-23.35)(P=0.007).After propensity score matching,the median survival time in High-RDW-SD group is 21.86 months(95%CI : 21.07-22.65),while time of Low-RDW-SD group is 22.81 months(95%CI:22.19-23.44)(P=0.043).The incidence of ischemic events in High-RDW-SD group was 2.089 times of Low-RDW-SD group(95%CI:1.173-3.720,P=0.012).Risk factors score=-3.544+0.675*Gender(male=1;female=2)+0.663*diabetes(yes=1;no=0)+History of myocardial infarction(yes=1;no=0)-0.01*Ccr+0.737*RDW-SD group(RDW-SD≤43.55fl=1;RDW-SD >43.55fl=2)+0.117*Unstable angina(UA)+0.586* Non ST segment elevation myocardial infarction(NSTEMI)+1.164* ST segment elevation myocardial infarction(STEMI).The area of ROC curve of risk factors score was 0.732(95%CI:0.668-0.796).Conclusion:RDW-SD has important predictive value for ischemic events after PCI in patients with anemia.Patients with high RDW-SD are prone to ischemic events.