| Objective To investigate the predictive value of preoperative RDW and RDW/PLT in patients with acute ST segment elevation myocardial infarction undergoing emergency percutaneous coronary intervention(PCI).Comparison of the relevance between the prognosis of patients with STEMI and preoperative levels of RDW and RDW/PLT in patients with STEMI.Methods(1)A total of 520 patients patients with a diagnosis of STEMI who underwent emergency primary PCI were included in this retrospective study,the Department of Cardiology,Navy General Hospital,from December 2013 to February 2016.According to the preoperative red cell distribution width(RDW),with a median method(median 13%)STEMI patients were divided into low RDW group(RDW<13%)and high RDW group(RDW≥ 13%),two groups of samples were 389 cases and 131 cases.Compared with the effect of preoperative RDW level and the incidence of MACE events,in patients with STEMI during hospitalization and 1 years after PCI,and study the prognostic factors of STEMI patients after PCI operation by univariate and multivariate Logistic regression analysis.(2)A total of 505 patients patients with a diagnosis of STEMI who underwent emergency primary PCI were included in this retrospective study,the Department of Cardiology,Navy General Hospital,from December 2013 to February 2016.According to the three percentile method(three quartile 6.86),the patients were divided into low RDW/PLT group(RDW/PLT≤6.86)and high RDW/PLT group(RDW/PLT > 6.86).Two groups of samples were 326 cases and 179 cases.Compared with the effects of RDW/PLT on the MACE events in patients with STEMI during hospitalization and 1 years after PCI.The prognostic factors of STEMI patients after percutaneous coronary intervention(PCI)investigated by univariate and multivariate Logistic regression analysis.Results(1)Compared with the low level of RDW group,the high RDW group of STEMI patients after PCI during the postoperative hospitalization’s MACE(4.7% vs 15.3%,P<0.001),and MACE of 1 years after PCI(9.3% vs 29%,P<0.001),the incident rate is higher,the difference was statistically significant(P<0.05).Univariate Logistic regression analysis,age(OR=1.019,95%CI: 1.001-1.039,P=0.044),hemoglobin(OR=0.985,95%CI: 0.972-0.998,P=0.024),RDW(OR=2.212,95%CI: 1.602-3.045,P<0.001),were statistically significant(P<0.05).Multivariate Logistic regression analysis,only RDW(OR=1.831,95%CI: 1.372-2.445,P<0.001)were statistically significant.(2)Compared with the low RDW/PLT group,high RDW/PLT group,PCI during postoperative hospitalization’s MACE(4.9% vs 11.7%,P<0.001),and MACE of 1 years after PCI(10.7% vs 24.4%,P=0.002),the incident rate is higher,the difference was statistically significant(P<0.05).Single factor logistic regression analysis,age(OR=1.044,95%CI: 1.026-1.062.P<0.001),BMI(OR=0.873,95%CI: 0.816-0.935,P<0.001),WBC(OR=1.062,95%CI: 1.001-1.127,P=0.047),LVEF(OR=0.954,95%CI: 0.932-0.976,P<0.001),PLT(OR=0.995,95%CI: 0.991-0.999,P=0.014)and RDW/PLT(OR=1.272,95%CI: 1.139-1.419,P<0.001),RDW(OR=1.382,95%CI: 1.102-1.732,P=0.005),were statistically significant factors(P<0.05).Multi Logistic regression analysis showed that age(OR=1.027,95%CI: 1.004-1.049,P=0.02),LVEF(OR=0.967,95%CI: 0.943-0.992,P=0.01),RDW/PLT(OR=1.435,95%CI: 1.121-1.835,P=0.004),were statistically significant.Conclusion(1)Preoperative RDW level in patients with STEMI has a high incidence of major cardiovascular events and a poor prognosis,and preoperative RDW levels predict the prognosis of patients with STEMI undergoing emergency percutaneous coronary intervention.(2)The incidence of MACE in patients with high RDW/PLT level before surgery was high,and the preoperative RDW/PLT level could predict the prognosis of patients with STEMI undergoing emergency percutaneous coronary intervention.(3)The preoperative RDW/PLT level was more significant than the preoperative RDW level in predicting the prognosis of patients with STEMI undergoing emergency coronary intervention. |
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