Red Blood Cell Distribution Width Combined GRACE Risk Score For Predicting The Risk Of Acute Coronary Syndrome Recent Death

Background and Objective: Red blood cell distribution width can bereflect the degree of dispersion corpuscular volume size accurately and objectively.Recent years more and more studies show that RDW be closely related tocardiovascular disease, it can be used as prognostic indicators, GRACE study is oneof the largest international, multi-center, prospective registry of acute coronary events,mainly used to predict hospital mortality. Although studies have shown that RDW andGRACE score were able to predict the prognosis of ACS, but the RDW joint GRACEscore predicted mortality in patients with recent ACS less coverage. This studycompares the level of RDW death group and non-group death in ACS patientscompared to a single combination of the two can evaluate the accuracy and sensitivityhigher.Research Methods: The study Select from January2013to January2014inour Hospital,According to the inclusion and exclusion criteria,412cases of patientswith acute coronary syndrome were selected,245cases were male, female167cases,aged44-85years, mean64±11.56the age of the study. Patients were measuredwithin24hours of admission RDW, RBC, Hb, WBC hs-CRP, GLU,SCr, TC, TG,LDL-C γ-GGT、BNP..Application GRACE score sheet scoring record of majorcardiovascular events in patients within30days, and all statistical analyzes wereperformed using SPSS19.0statistical software package for analysis. Measurementdata were presented as mean±standard deviation (±s), that count data to rate orfrequency, that the t test was used to compare the data between the two groups.Pearson correlation analysis was performed using two-factor correlation analysis, astatistically significant correlation coefficient Multivariate linear regression screeningfactors can affect the RDW. The use of receiver operating characteristic curve(receiver operating characterist ROC) analysis area GRACE score and RDW levelsand their combination on the30-day mortality in patients with ACS predictive value to P <0.05was considered statistically significant.Research Results: By Kaplan-Meier survival curve analysis showed that, RDWlevel of≥13%(mean of13.09±1.14) compared with short-term prognosis RDWlevels <13%survival rate was significantly lower (Log rank10.897, P=0.001),GRACE risk score <130mean (130.15±31.55) in the short-term prognosis ofpatients with ACS is better than GRACE≥130receiver operating characteristic (Logrank24.423, P <0.001)30days deaths occurred curve (ROC), RDW area under thecurve (AUC) was0.757, RDW area under the curve (AUC) of0.750,0.826both joint,Univariate analysis by RDW levels and GRACE score, WBC, hs-CRP, SCr, BNP,γ-GGT has, the correlation coefficients were0.406,0.563,0.522,0.483,0.713,0.457, P<0.05differences were statistical significance.multivariate linear regression, theGRACE score, WBC, hs-CRP, still positively correlated with RDW, partial correlationcoefficients were0.396,0.452,0.518, P <0.05differences were statistically significant.Conclusions:1. RDW and GRACE risk score combination can improve the prediction ofmortality in patients with ACS.2. RDW levels correlated with the GRACE score.3. Level of RDW≥13%compared with short-term prognosis RDW levels <13%death rate was significantly higher.4. RDW as predicting acute coronary syndrome independent predictor risk ofdeath within30days.