The Research Of The Relationship Of Red Blood Cell Distribution Width And Major Adverse Cardiovascular Events In Patients With Acute Myocardial Infarction

Objective:To investigate the relationship of red blood cell distribution width(RDW) and major adverse cardiovascular events(MACE) in patients with acute myocardial infarction(AMI) during hospitalization.Methods:1 、 From January 2008 to December 2012, 202 AMI patients admitted in cardiology department of the fist Affiliated Hospital of Nanchang University were enrolled.The general situation、related history、red blood cell distribution width、mean corpuscular volume、platelet distribution width、mean platelet volume、hemoglobin、albumin、alanine aminotransferase enzyme、aspartate aminotransferase、blood urea nitrogen、serum creatinine、uric acid、blood lipids、left ventricular-ejection fraction of all the patients were recorded during hospitalization.2、The patients were divided into positive group(A group,n=62) and negative group(B group,n=140) after admission according to the occurrence of MACE or not,including acute left heart failure、cardiac shock、arrhythmia、recurrent angina、Adams-Stokes Syndrome and death during hospitalization, RDW was compared between the two groups.3、According to the median of RDW measured for the fist time in 24 hours,All patients were divided into two groups:lower group(C group,RDW≤12.9%,n=106),higher group(D group,RDW>12.9%,n=96),Then we compared the relationship of major adverse cardiovascular events and RDW between the lower and higher group when they were hospitalized.4、The Killip classification is executed by cardiologist depended on the clinical symptoms、the rale of lung、the scope of rale and the blood pressure,investigating the relationship of RDW and Killip classification of the patients with acute myocardial infarction.Results:1、RDW levels in MACE positive group was significantly higher than that in MACE negative group(13.62±0.58%VS 12.66±0.67%,P<0.05),Multivariate Logistic regression analysis showed that RDW may be an independent predictive factor of the occurrence of major adverse cardiovascular events in patients with AMI.2、The major adverse cardiovascular events occurred more frequently among patients with higher RDW(RDW > 12.9 %) than those with lower RDW(RDW ≤12.9%) during hospitalization(P<0.05).3、The RDW of patients in Killip class II and III was higher than those in Killip class I(PI/II=0.012<0.05,PI/III<0.001),but the difference of RDW between Killip Class II and III was not significant(PII/III=0.116>0.05).Conclusions:RDW is closely related to the occurrence of major adverse cardiovascular events in patients with acute myocardial infarction during hospitalization,Which may be an independent predictive factor of the occurrence of major adverse cardiovascular events in patients with AMI.