| Background：It has been reported that increased red blood cell width (RDW) is amarker associated with the presence and adverse outcomes of various cardiovasculardiseases. However, the gender difference of RDW in predicting the presence ofcoronary heart disease (CHD) has not been investigated.The aim of the present studywas prospectively evaluate the severity of CHD and RDW in a large Chinese cohort，butalso was explore the gender differences in the association of RDW and CHD.Methods：A total of677consecutively admitted individuals between May2011and May2012in Fu Wai Hospital in Beijing, China. All patients who had receivedcoronary angiography (CAG) were enrolled and then were divided into the two groupsbased on the results of CAG: CHD group (n=499, male=352, female=147), and controlgroup (n=178, male=91, female=87). The baseline clinical characteristics includingtraditional CHD risk factors were collected, and RDW were analyzed to identify theirrelationship to CHD. The severity of CHD was evaluated by modified Gensini score,and its relationship with RDW was also analyzed. Further, the gender differences ofRDW in predicting the presence of CHD were also evaluated. Multivariate logisticregression analysis was used to identify the independent predictor for both angiographicCHD and CHD in gender differences; In a receiver operating characteristic (ROC) curveanalysis, an RDW value of was identified as an effective cut-point in the segregation ofthe presence or absence of CHD and CHD in gender differences. Statistical analyseswere carried out using SPSS19.0(SPSS Inc., Chicago, Illinois, USA) software.Results：(1) Patients with angiographic CHD had significantly elevated RDWlevels compared with those without CHD (12.95±0.77vs.12.73±0.83, P=0.001).There was a significantly positive correlation between RDW and the Gensini score (r=0.37, P＜0.001). In multivariate Logistic regression analysis, RDW was observed to bean independent predictor for both angiographic CHD (OR=1.34,95%CI:1.02～1.77, P ＜0.05) and for a high Gensini score (OR=2.23,95%CI:1.62～3.08, P＜0.001).respectively. The diagnostic accuracy of RDW, as calculated by the receiver operatingcharacteristic (ROC) curve analysis, area under curve (AUC) was0.61(P<0.001).anRDW value of12.85%was identified as an effective cut-point in predicting thepresence or absence of CHD with a sensitivity of50.0%and a specificity of65.2%.(2) There were significant gender differences in age，smoking history，familyhistory，and hemoglobin levels (P＜0.05), However, the levels of RDW were similar inboth groups (P>0.05), indicating that sex itself has little effect on the variation of RDW.Although there was no difference in RDW levels between men and women in a total ofindividuals, the levels of RDW were higher in female patients with CHD than that inones with control (12.9±0.7vs12.6±0.6, p=0.001). Additionally, the levels of RDWwas similar between male patients with CHD and male controls (13.0±0.8vs12.8±1.0, p=0.144). Univariate logistic regression analysis indicated that age, diabetes,hypertension, dyslipidemia, family history as well as RDW were the risk factors forpredicting CHD in female individuals. We put those6variables into the multivariatelogistic regression analysis, and found that age and RDW were independent predictorsof female patients with CHD (OR=1.07,95%CI:1.03～1.10, p<0.001; OR=2.03,95%CI:1.28～3.23, p<0.01). In a ROC curve analysis CHD in female patients, AUC was0.63(P<0.001), at the cut-off value of12.75%, the clinical sensitivity and specificity ofRDW on admission were57.1%and66.3%,Conclusions：RDW is associated with both presence of CHD and the severity ofcoronary stenosis, suggesting that it might be a readily available marker for theprediction of CHD and its severity. Taken together, in the presence study, we, for thefirst time, demonstrated that RDW was closely associated to women with CHD acrossgender strata, and high RDW was a significantly independent predictor of CHD inwomen. |
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