Relationship Between Red Blood Cell Distribution Width And Adverse Cardiovascular Event Of Acute Myocardial Infarction During Hospitalization After Direct PCI

Objective:To investigate the relationship between red blood cell distribution width(RDW)and the risk of adverse cardiovascular event during hospitalization in patients with acute myocardial infarction(AMI)after direct percutaneous coronary intervention(PCI).Subjects and methods:Admission from February 2015 to May 2017 in 228 patients with acute myocardial infarction and underwent direct PCI operation in the Department of cardiovascular medicine in First Hospital Affiliated to Nanhua University.According to the incidence of adverse cardiovascular events during hospitalization,divided into event group and non-event group.Comparison of clinical data between the two groups,then multivariate regression analysis of statistically significant factors.The ROC curve was used to analyze the predictive value of RDW for adverse cardiovascular events during hospitalization after direct PCI operation in patients with acute myocardial infarction,and the best truncation value was selected.RDW was divided into two groups:RDW high value group and RDW low value group.Comparison of clinical data and adverse cardiovascular event between the two groups.The odds ratio of adverse cardiovascular event at different RDW levels was calculated by Logistic regression.Spearman grade correlation was compared between RDW with CRP and NT-proBNP.Results:1.228 patients with acute myocardial infarction after direct PCI,74 had adverse cardiovascular events during hospitalization(47 patients with heart failure,10 patients with cardiogenic shock,19 patients with malignant arrhythmia,3 patients with Cardiac arrest,2 patients with stent thrombosis,1 patients with revascularization,1 patients with cardiac death).The levels of RDW,CRP,NT-proBNP and hs-cTnT in event group were significantly higher than those in non-event group(P<0.05).After multivariate regression analysis,find that RDW(OR=1.812,95 % CI: 1.050~3.127,P<0.05),CRP(OR=1.083,95 % CI: 1.004~1.169,P<0.05),NT-proBNP(OR=1.883,95%CI: 1.024~3.462,P<0.05)as an independent risk factor for adverse cardiovascular events in patients with AMI after direct PCI operation.2.The ROC curve was used to analyze the predictive value of RDW for adverse cardiovascular events during hospitalization after direct PCI operation in patients with acute myocardial infarction,the area under the curve was 0.656.The optimum truncation value was 13.15.The sensitivity was 0.541 and the specificity was 0.74.3.Comparison RDW high value group(≥13.15)and RDW group(<13.15)low value comparison.Age,LVDd,CRP,NT-proBNP,hs-cTnT and the incidence of adverse cardiovascular event in RDW high value group was significantly higher than that in RDW low value group,and the difference was statistically significant(P<0.05).But the HDL,SBP,DBP of high value group was lower than that of the low value group of RDW,The difference was statistically significant(P<0.05).After adjusting for other confounding factors,the risk of adverse cardiovascular event in RDW high value group was 2.061 times than those with low RDW values(95% confidence interval: 1.071~3.964,P<0.05).4.There was a positive correlation between RDW and plasma CRP,NT-proBNP,The rank correlation coefficients are 0.344 and 0.270 respectively,P<0.05.Conclusion:High red blood cell distribution width level is closely associated with the risk of adverse cardiovascular event during hospitalization in patients with acute myocardial infarction after direct PCI,and may be an independent predictor of adverse cardiovascular events during hospitalization after direct PCI in patients with acute myocardial infarction.