Prognostic Value Of Red Blood Cell Distribution Width On Bleeding Events In Paroxysmal Non-valvular Atrial Fibrillation Patients Taking Dabigatran After Catheter Ablation

Objective:many studies have shown that there is close correlation between red cell distribution width(RDW)and cardiovascular disease such as coronary heart disease,heart failure and atrial fibrillation.The HAS-BLED scoring system is currently the most widely used bleeding risk assessment system for atrial fibrillation.This study aims to investigate the correlation between RDW and HAS-BLED score.The aim of this study was to investigate the correlation between RDW and HAS-BLED scores and the predictive value of true bleeding events in patients with paroxysmal non-valvular atrial fibrillation(NVAF)during administration of 110mg of dabigatran for twice a day after catheter ablation.Study design and method:1.There were 172 patients with paroxysmal non-valvular atrial fibrillation(NVAF)who were enrolled in the Jiangsu Province People's Hospital from January 2014 to January 2015.All patients were given Dabigatran etexilate(DE)110 mg tw:ice daily for three weeks before hospitalized.They were admitted with age,sex,height,weight,Diabetes mellit,stroke history and other clinical data.Blood samples were collected in the DE Valley concentration in the morning after admission.The main monitoring items include RDW,activated partial thromboplastin time(activated partial thromboplastin time,APTT),hemoglobin,Liver and kidney function.The HAS-BLED score of patients was calculated when hospitalized.2.All patients were divided into high HAS-BLED score group(?3 points)and low HAS-BLED score group(<3 points)according to the HAS-BLED score.The receiver operating characteristic curve(ROC)were used to evaluate the predictive value of RDW on high HAS-BLED score(?3 scores).Multiple logistic regression analysis was used to analyze the independent predictor of high HAS-BLED score.3.All patients were followed up for 3 months after catheter ablation to observe the occurrence of bleeding events.The predictive value of RDW on bleeding events was assessed through ROC curve.Multivariate Cox proportional hazards model analysis was used to assess whether RDW could be an independent predictor of bleeding events.Result:1.the RDW of high HAS-BLED score group was higher than it of no-high HAS-BLED score group(13.9610.93%vs13.08±1.03%,P=0.000).There was a significant positive correlation between RDW and HAS-BLED scores(r = 0.393,P<0.0001).The area under the receiver operating characteristic curve of RDW was 0.796(95%CI:0.740-0.844,P<0.0001)to predict high HAS-BLED score.Multiple logistic regression analysis showed that high RDW value could be used as the independent predictor of high HAS-BLED.2.13 cases of bleeding events,all of which were minor bleeding,occurred after a 3-month follow-up,among which 3 cases were gingival bleeding,3 were urinary tract bleeding,3 were conjunctival hemorrhage,and 4 were subcutaneous hemorrhage.The ROC areas under curve for RDW to predict the occurrence of bleeding event were 0.737(95%CI:0.616-0.875,cut-off point-13.25%,P<0.001).Multivariate Cox regression analysis showed that high RDW could be used as an independent predictor of bleeding events(HR:1.91,95%CI:1.03-3.98,P = 0.031).Conclusion:1.RDW value is associated with HAS-BLED value,which can be used as the independent predictive factor of high HAS-BLED score.2.RDW was associated with the occurrence of bleeding event in paroxysmal NVAF patients that took dabigatran(110mg for twice a day)after ablation,while also being an independent predictor of bleeding events.RDW ? 13.25%can be treated as a warning index for bleeding events.