Study Of The Correlation Between Red Blood Cells,Platelets Parameters In The Patients With Coronary Heart Disease And Heart Failure

BackgroundThe size variability of red blood cell distribution width is associated more closely to the incident,development,and its usefulness in early risk detection of patients with HF or CHD.Therefore,Erythrocytes has a certain reference value and its elevation in patients with cardiovascular disease can give many useful data onto medical health cares and it could be used as a reference to treat coronary heart disease or heart failure.The aim of our study was to investigate the potential role and Correlation between Red Blood Cell Parameter in patients with cardiovascular disease,as well as to assess the prediction value of platelet distribution width in patients with Coronary heart disease and heart failure.Furthermore,we attempted to preliminary study and to determine whether the combined use of RDW,MPV,PDW,P-LCR and other biomarkers had prognostic value that could improve disease prediction and provide a reference for clinical treatment in the prediction and stratification of high risk patients.Part One:Study of the Correlation between Red Blood Cell Parameters in the Patients with Coronary Heart Disease and Heart FailurePurposeAn increase of red blood cell distribution width may have a certain effect to predict and evaluate the incidence and prognosis of coronary heart disease or chronic heart failure.Method and SubjectsA total of 230 patients were enrolled in the Department of Cardiology at Northern Jiangsu people’s Hospital during the period from January 2015 to December 2016.All patients Performed Coronary angiography in our department.Regarding to their results of coronary angiography,the Patients had been separated into two categories;coronary angiography negative CAG(-)group(n=100),among them 55 patients were male and 45 patients were female and Coronary angiography positive CAG(+)group,(n=130)among them,100 patients were male and 30 patients were females,the overall numbers of male patients(67.4%)and female(32.6%)patients,with an average age over 61 years,the two groups were compared in order to investigate the differences between their RDW and other factors related,then further were subdivided into 4 groups according to the NYHA Functional Class which is CAG(-)/NYHA Ⅰ,CAG(-)/NYHAⅡ～Ⅳ,CAG(+)/(NYHA Ⅰ)and CAG(+)/(NYHAⅡ～Ⅳ).Meanwhile,we used statically analysis to investigate the correlation mechanism between the heart failure and red blood cells distribution width,LAD,LVEF,LVEDD and other markers,furthermore the Two groups were separated according to echocardiography,laboratory reports and refer to(NYHA function class);All the data were statistically analyzed to assess the correlation between the variables in the patients and controls using SPSS 19.ResultsWe observed that the patients in CAG(-)group 12.78±0.90 and CAG(+)group 12.90±1.10 and had no significant difference in the RDW.However higher RDW in patients with heart failure on all-cause was detected,13.50±1.12 of group CAG(-)/NYHAⅡ-Ⅳ and 13.39±1.31 of group CAG(+)/NYHAⅡ-Ⅳ and there are significant statistical difference compared to group CAG(-)/NYHAI and group CAG(+)/NYHAI which were 12.80±0.47 and 12.87±0.69 with(P 0.001).In addition,there has no difference between the heart failure group CAG(-)/NYHA Ⅱ～Ⅳand CAG(+)/NYHA Ⅱ～Ⅳ group(P=0.920),and no difference between groups without-heart-failure of(P=0.979).For an instant,RDW remains an independent factor that associated with Chronic heart failure(regression coefficient=0.880,OR=2.411,P<0.01)after adjustment for other predictors and prognostic factors of heart failure such as age,EF,Hb,LEVDD,LAD,Alb,and UA.ConclusionAlthough RDW had no predictive ability of coronary heart disease,but the elevation of RDW was highly and independently associated with chronic HF.Therefore,RDW can be clinically used as a parameter in risk stratification of patients with heart failure.Part Two:Study of the Correlation between Platelet Parameters in the Patients with Coronary Heart DiseasePurposeThe incidence and development of coronary heart disease are ultimately associated with the size and function of platelet.Our study aimed to determine the clinical value of platelet distribution width as an indicator for prediction or risk stratification of coronary heart disease by retrospective analysis of particular population.Method and SubjectsA total of one hundred and fifty patients had been enrolled in the Department of Cardiology at Northern Jiangsu people’s Hospital,during from January 2015 to December 2016.All patients Performed Coronary angiography in our department and were excluded patients with diseases such as,Atrial fibrillation,DCM,VHD.The control group N-CHD(n=45)were the participants without Coronary heart disease confirmed by CAG examination,including 25 male,20 female patients.The S-CHD group(n=58)containing 42 male and 16 female patients,were the patients with stable-type of Coronary heart disease confirmed diagnosis by coronary angiographic examination and patients with repeated CAG-examination or post-CABG were excluded.The group ASC(n=47)among them,37 male and 10 patients were the patients who suffering Acute coronary syndrome episode(both myocardial infarction and unstable angina)at admission and received CAG and other Interventional treatment thereafter.Statistical methods,including one-way ANOVA,correlation analysis;multivariate linear regression analyses have been applied to investigate their co-relationship and correlations with other blood biomarkersResultsThe PDW of S-CHD and ACS have been13.85 ± 2.68 and 13.89±1.16,respectively,and there has been no significant difference,while,the PDW of the N-CHD group wasl2.58 ± 2.11,and the values of the first two groups have been significantly higher than those of the N-CHD group.In addition,the MPV and P-LCR of S-CHD have been significantly higher than the ones of N-CHD group {11.14 ±1.17 vs 10.51 ± 0.91 and 32.71 ± 9.99 vs 28.41 ± 7.69,(P<0.01)};However,there has been no huge distinction between S-CHD and ACS.Furthermore,after modifying for other risk parameters such as,age and gender,PDW was still positively correlated with Coronary heart disease(OR =1.341 and 1.349,P<0.01)in S-CHD group and ACS group.ConclusionPDW,MPV,and P-LCR are the platelet volume indicators that can reflex the variability of circulation platelets;their increase was highly and positively associated with Coronary heart disease.Therefore they may be the valuable independent indicators for risk stratification and Prediction of coronary heart disease and it can be useful in clinical practice.Further investigation of the mechanisms associated with coronary heart disease and large platelet will allow us to understand better the mechanisms,the development and the pathophysiology of Coronary Heart Disease.It is also important to seek an effective strategy for Coronary Heart Disease prevention and treatment.