| Introduction: Red cell distribution width (RDW) has been shown to associate with adverse outcomes in
various cardiovascular diseases. We aimed to explore the predictive value of RDW for resolution of the
ST segment (STR) after thrombolytic therapy in patients with ST elevation myocardial infarction
(STEMI).
Methods: Patients with STEMI with indication for thrombolytic therapy were recruited from a university
center between 2013 and 2015. A comprehensive laboratory investigation at the time of admission
included measurement of RDW. Following thrombolysis ST segment resolution was assessed after 90
minutes. A positive response (STR ≥ 50%) was the primary endpoint. Secondary endpoints were major
adverse cardiac events (MACE) defined as occurrence of acute heart failure, ventricular dysrhythmia
beyond the first 24 hours, cardiac arrest or death during hospitalization.
Results: A total of 312 patients (271 male) with the mean age of 57.9±12.3 were enrolled. RDW on
admission was 14.1±1.0% (range: 11.6-17.7%). STR was seen in 191 cases (61.2%). MACE occurred in
36 (11.5%) patients. The long-term mortality rate was 7.1% during the follow-up period of 7.7±3.2
months. Even after adjusting for co-morbid conditions, in multivariate model, baseline RDW,
independently predicts STR (RR=2.46, 95% CI 1.32-4.57, P=0.005) and in hospital occurrence of MACE
(RR=3.17, 95% CI 1.23-8.46, p=0.017). The cut-off values for RDW in predicting STR and MACE were
14.2% and 14.4%, respectively.
Conclusion: An elevated baseline RDW could predict adverse outcomes and response to thrombolytic
therapy in patients with STEMI. This extends our knowledge about RDW value in prognostication. |