Changes In RDW In Patients With Acute Myocardial Infarction And Relationship Between RDW And Clinical Outcomes

Objective To observe the differences in erythrocyte parameters between patients with different types of coronary heart disease and normal control subjects; Dynamic changes in erythrocyte parameters in patients with acute myocardial infarction(AMI) and relationship between red cell distribution width (RDW)and major adverse cardiac event(MACE).Methods (1)Erythrocyte parameters were measured in65patients with stable angina pectoris(SAP),59patients with unstable angina pectoris(UAP),100patients with acute myocardial infarction(AMI) and63normal control subjects.(2)Baseline erythrocyte parameters were compared between non-ST-elevated myocardial infarction(NSTEMI) and ST-elevated myocardial infarction(STEMI),among different cardiac function (Killip classes).(3) A longitudinal study of erythrocyte parameters measurements in patients with AMI every3days postinfarction. Baseline RDW and changes in RDW were analysed to test the variability between and within subjects.(4)RDW was compared between patients with and without MACE, including acute left heart failure, shock, death and arrhythmias during hospitalization.Results (1)Compararisons between patients with different types of coronary heart disease and normal subjects:no significant changes occurred in RBC,HB,HCT. MCV,MCH,MCHC changed significantly (P<0.05);RDW and MCV increased, meanwhile MCHC decreased in patients with unstable angina pectoris and acute myocardial infarction(P<0.05).(2)No significant changes occurred between NSTEMI and STEMI, among different cardiac function.(3)The linear correlation analysis showed:hs-CRP, disease grouping, age were positively correlated with RDW; RBC, HB, MCHC were negatively correlated with RDW(P<0.05); By multiple stepwise linear regression analysis where RDW was regarded as the dependent variable,we found the multiple linear regression equations as follows: RDW=0.143age-0.275MCHC+0.423MACE+19.176, r2=0.322。(4)Compared with the first3days postinfarction, RBC、HB、HCT decreased,meanwhile MCV,MCH increased during days4to9. RDW increased in the first3days postinfarction, peaking over the next3days, and then decreased during days7to9(5)Compared with patients without MACE, RDW was higher in patients with MACE during the first9days postinfarction (P<0.05).Conclusion(1) RDW were higher in patients with UAP and AMI.(2) Baseline RDW in patients with different types of cornory heart disease:AMI>UAP>SAP. (3) RDW increased in the first3days postinfarction, peaking over the next3days, and then decreased during days7to9.(4) Compared with patients without MACE, RDW was higher in patients with MACE during the first9days postinfarction. RDW might be associated with MACE during hospitalization.