Correlation Between Red Blood Cell Distribution Width, Mean Platelet Volume And Premature Coronary Artery Disease

Objective: To investigate the distribution of red cell distribution width(RDW)and mean platelet volume(MPV)levels in patients with premature coronary artery disease(PCAD),and the relationship between RDW,MPV and the clinical type of PCAD and severity of coronary lesions in patients with PCAD.Methods: A total of 407 patients with suspected coronary artery disease(CAD)due to chest pain in the First Affiliated Hospital of Shihezi University from September 2016 to September 2018 and who met male <55 years old and female <65 years old were be enrolled in the study,including 219 males,mean age(48.6±5.0)years old,188 females,mean age(55.5±6.4)years old.All patients received Coronary angiography(CAG),and were divided into PCAD group(n=309)and control group(n=98).The PCAD group included stable angina(SAP)group(n=102),unstable angina pectoris(UAP)group(n=101)and acute myocardial infarction(AMI)group(n=106).All the patients were recorded patient age,gender,smoking,disease history,medication history,height and weight,and blood biochemical indicators such as RDW and MPV were detected.The degree of coronary lesions was assessed using the Gensini score of the American Heart Association.The data were analyzed by SPSS 22.0 statistical software.The measurement data of normal distribution were represented by mean ± standard deviation,the two groups were compared by t test,The mean between multiple groups was compared by one-way ANOVA.The count data was compared by Chi-square test.Spearman method was used to analyze the correlation between RDW,MPV levels and coronary Gensini score.Multivariate logistic regression was used to analyze the independent risk factors of PCAD.The ROC curves of RDW and MPV in the diagnosis of PCAD were drawn.P < 0.05 was used as the test level.Results:(1)Compared with the control group,the levels of RDW and MPV in the PCAD group were significantly increased,and the difference was statistically significant(P<0.05).(2)The levels of RDW and MPV in the subgroup of PCAD were higher than those in the control group(P<0.05),and the RDW levels were in the AMI group>UAP group>SAP group(P<0.05),but the MPV levels in the AMI group and UAP group were higher than the control group.There was no significant difference in MPV levels between the AMI group and the UAP group(P>0.05).(3)RDW and MPV levels in patients with PCAD were correlated with Gensini score by double-variable Spearman.The results showed that RDW and MPV levels were positively correlated with Gensini score(r=0.246,P<0.05;r=0.199,P <0.05).(4)Multivariate logistic regression analysis of PCAD as a dependent variable showed that age,smoking,RDW,MPV,white blood cell(WBC),and low-density lipoprotein cholesterol(LDL-C)were independent risk factors of PCAD(P<0.05).(5)To study the ROC curve of RDW and MPV in the diagnosis of PCAD.The boundary value of RDW in the diagnosis of PCAD was 12.25%,and the area under the ROC curve was 0.76(95% CI: 0.71-0.82,P<0.05).The sensitivity was 69% and the specificity was 72%.The boundary value of MPV diagnosis of PCAD was 8.55 fl,the area under the ROC curve was 0.66(95% CI: 0.60-0.73,P<0.05),and the sensitivity was 91%,Specificity 37%.Conclusions:(1)RDW and MPV are associated with the clinical type of PCAD.The higher the RDW and MPV levels,the more severe the clinical subtype,but there is no significant difference in MPV levels between patients with UAP and AMI;(2)The levels of RDW and MPV are positively correlated with the Gensini score of PCAD,indicating that the higher the level of RDW and MPV,the more severe the severity of coronary lesions in PCAD;(3)RDW and MPV are independently associated with the occurrence of PCAD,which may provide a new idea for clinical diagnosis of PCAD.