| Objective: RDW, as a hematological parameter, has been used todifferentiate and diagnose for anemia. Recent studies have indicated that thereis a significant association among RDW and hypertension, stroke, carotidatherosclerosis, coronary heart disease, the stability of acute coronarysyndromes and heart failure and other cardiovascular and cerebrovasculardiseases, and it has an important value in assessing the risk and prognosis ofthis disease. As reported in the foreign literature, there is positive correlationbetween the RDW and SYNTAX score, which reflects on the complexanatomical degree of coronary artery disease. RDW for patients with coronaryheart disease have a certain significance to guide choice of reperfusionstrategy. But there is little coverage literature about relationship among RDW,extent of coronary atherosclerosis and the severity of coronary heart disease indomestic and international literature.The aim of this study was to use Gensiniscore for the evaluation of the severity of coronary artery disease in patientsundergoing coronary angiography, and to observe the relationship between thelevel of RDW and the incidence of coronary heart disease and coronary arterylesions of Gensini score.Methods:1. Subject:416cases of patients with coronary heart diseasewere selected from the Department of Cardiology and Cardiovascular careunit (CCU) of Beijing Chui Yang Liu Hospital in hospitalized patientsdiagnosed by coronary angiography from2011Jan to2012June. There are180cases of acute myocardial infarction (AMI) patients including129menand36women with the age ranging from32to86, average age (59.55±12.31).There are188cases of unstable angina pectoris (UAP) patients including101men and87women with the age ranging from34to85, average age(64.55±11.17). There are63cases of stable angina pectoris (SAP) patientsincluding30men and33women with the age ranging from29to79, average age (61.21±10.10). The normal control group:97patients with negativecoronary angiography results were selected as the normal control group,including40men and57women with the age ranging from25to81, averageage (56.72±10.09).2. Exclusion standard: Serious heart failure (NYHA Ⅲ～Ⅳ, Killip Ⅲ-Ⅳ); Chronic obstructive pulmonary disease (COPD); Severeliver or kidney dysfunction; Acute or chronic infections, blood diseases,malignant tumors and connective tissue diseases and rheumatic diseases; Amajor operation or severe trauma history within half a year; A history of bloodtransfusion within three months; Severe anemia (hemoglobin<90g/L).3.Information collected and observed: Collect the clinical data of patients,including gender, age, history of disease and clinical diagnosis. Vein bloodwas drawn from fasting, and white blood cell count (WBC), red blood cellcount (RBC), hemoglobin (Hb), mean corpuscular volume (MCV), hematocrit(HCT), RDW, neutrophil counts (GRA), monocyte count (Mon), highsensitive C reactive protein (hs-CRP), fasting blood glucose (GLU),glycosylated hemoglobin (HbAlc), cholesterol (TC), triglyceride (TG), highdensity lipoprotein (HDL-C), low density lipoprotein (LDL-C), total bilirubin(TBIL), creatinine (CRE), uric acid (UA) were tested. Standard techniqueswere used in CAG, and interventional cardiovascular physician evaluate theresults of Coronary angiography. All statistical analyses were performed bySPSS19.0software, and P value<0.05was considered statistically significant.Results:1. Generally clinical characteristic description:1.1There wereno differences between CHD group and control group in RBC, MCV, HCT,Hb, TCH, TG, HDL-C, LDL-C, CRE and the proportion of hyperlipidemia(P>0.05). There were significant difference in the proportion history ofhypertension, history of diabetes, male and the level of age, GLU, UA, TBIL,HbAlc between the two groups (P<0.05). The proportion of the history ofhypertension, history of diabetes, history of smoking, male and the level ofGLU, HbAlc, TBIL were higher than those in control group(P<0.05).1.2There were no significant difference in the proportion of the history ofdiabetes, the history of hyperlipidemia and the level of Hb, HCT, MCV, TBIL, TCH, TG, LDL-C and HbAlc among the SAP group, UAP group and AMIgroup (P>0.05). There were significant differencethe in the proportion of thehistory of hypertension, history of smoking, male and the level of GLU, UA,CRE, HDL, RBC among the three groups (P<0.05). The age of UAP groupwas higher than that of AMI group and SAP group (P<0.05), but there was nosignificant difference between SAP group and AMI group (P<0.05); Theproportion of the history of hypertension in SAP group and UAP group washigher than that of AMI group (P<0.05), but there was no significantdifference between SAP group and UAP group (P<0.05). The level of HDL-Cin SAP group was higher than that in UAP group (P<0.05), and there was nosignificant difference between SAP and AMI group and between UAP groupand AMI group (P>0.05). The proportion of the history of smoking, male, andthe level of RBC, GLU, UA, CRE in AMI group were significantly higherthan those in UAP group and SAP group (P<0.05); The level of CRE and UAin UAP group higher than those of SAP group (P<0.05); There were nodifferences between UAP group and SAP group in the proportion of thehistory of smoking and the level of RBC and GLU (P>0.05).2. The Comparison of the level of RDW and other inflammatoryindicators between the control group and CHD group showed that the level ofRDW in the CHD group (12.51±0.92) was significantly higher than that of thecontrol group (11.76±0.66)(P=0.000);The level of WBC in the CHD group(8.76±3.36) was significantly higher than that of the control group(6.73±1.85)(P=0.000); The level of hs-CRP in the CHD group (10.98±1.09)was significantly higher than that of the control group (4.79±0.79)(P=0.000);The level of GRA in the CHD group (5.98±3.10) was higher than that of thecontrol group (4.23±1.65)(P=0.000); With the worse of the coronary artery,the level of Mon increased also, but there was no significantdifference(P=0.052).3. The Comparison among various types of coronary heart disease in thelevel of RDW and other inflammatory indexes: RDW in AMI group(12.75±0.93) is significantly higher than that in UAP group (12.43±0.94) and SAP group (12.14±0.63), and the level of RDW in UAP group is significantlyhigher than that in SAP group, there were statistically significant differenceamong the three groups (P=0.000, P=0.000, P=0.011). The level of WBC inAMI group (10.80±3.80) is higher than that in UAP group (7.48±2.22) andSAP group (7.18±2.00)(P=0.000, P=0.000); but there was no significantdifference between UAP group and SAP group (P=0.145). The level ofhs-CRP in AMI group (17.83±2.09)was higher than that of UAP group(7.44±1.42)and SAP group (3.84±1.15), and the level of hs-CRP in UAP groupwas significantly higher than that in SAP group, there were statisticallysignificant difference among the three groups (P=0.000, P=0.000, P=0.013).The level of GRA in AMI group (7.98±3.66) is higher than that in UAP group(4.71±1.70) and SAP group (4.51±1.56)(P=0.000, P=0.000), but nosignificant difference between UAP group and SAP group (P=0.181). Mon inAMI group (0.61±0.31) was higher than that in UAP group (0.48±0.20) andSAP group (0.43±0.15)(P=0.000，P=0.000), but there was no significantdifference between UAP group and SAP group (P=0.060).4. The correlation among the RDW, hs-CRP and WBC: According tolinear correlation analysis, the levels of RDW are positively correlated withhs-CRP and WBC(r=0.174, P=0.000; r=0.108, P=0.027).5. To analyze the relationship between the level of RDW in patients withcoronary heart disease and the severity of coronary artery disease (Gensiniscore) by bivariate Spearman correlation analysis, the result showed that thelevel of RDW were positively correlated with Gensini score. With theincreasing of Gensini score, RDW also increased (r=0.294, P<0.001). Take theGensini score as the dependent variable, and RDW, TG, TC, HDL-C, LDL-Cand so on as the independent variable, stepwise regression analysis was made,the results showed that: The RDW was included in the regression eguation, theGensini score was related with RDW (r=10.896, P=0.000).6. Take the incidence of coronary artery disease (no=0, yes=1) as thedependent variable, and gender, and the history of hypertension, the history ofdiabetes, the history of hyperlipidemia, smoking history, age, RDW, WBC, hs-CRP, GLU, TC, TG, HDL-C, LDL-C, CRE, UA as the independentvariable, the resulted show that RDW was independently associated withcoronary heart disease (r=1.012, OR=2.751, P=0.000).Conclusion:1. The levels of RDW are positively correlated with hs-CRPand WBC, which showed that the increase of RDW may reflect the state ofchronic inflammation of body.2. With the worse of the severity of coronary artery stenosis, the level ofRDW is increased. There was a significant linear correlation between theRDW and Gensini score.3. The level of RDW are closely related with the stability of coronaryheart disease, the clinical type of CHD groups is more unstable, the level ofRDW is more higher.4. The level of RDW are closely related with the pathogenesis ofcoronary heart disease, logistic regression analysis showed, in effectcorrection factors, the level of RDW remained an independent predictivefactor of CHD. |
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