Red cell distribution width: A marker of in-hospital mortality in ST-segment elevation myocardial infarction patients?

Abstract

Background

Red cell distribution width (RDW) is the percentage of the erythrocyte volume variation and has been identified as a biological marker in patients with cardiovascular disease. Increased levels have been associated to worse clinical outcomes and it is suggested that it could be useful as a prognostic risk factor in this group of patients.

Methods

This was an observational, prospective, longitudinal and analytic study with the objective of determining the correlation between RDW and in-hospital mortality in ST elevation myocardial infarction (STEMI) patients. 61 patients were included. We analyzed the correlation between RDW and in-hospital mortality as well as that between RDW and the GRACE risk score at hospital admission. Pearson correlation was determined in both cases by using IBM SPSS statistics software.

Results

61 STEMI patients were included, 77% (47) male and 14% (14) female. Average age was 61.8 ± 11.7 years. Average GRACE risk score was 154.9 ± 40.3. Average RDW was 14.3 ± 1.07. In-hospital mortality presented in 5 (8.1%) cases. It was found, as expected, a positive correlation between in-hospital mortality and the GRACE risk score (r = 0.314, P = 0.05). Regarding the primary end-point of the study, it was found a positive correlation between RDW and in-hospital mortality (r = 0.343), however there was no statistical significance. Regarding the secondary end-point we observed a positive statistically significant correlation between RDW and the GRACE risk score at hospital admission (r = 0.410, P = 0.01).

Conclusions

RDW is a biological marker of easy acquisition that does not generate additional cost to neither the patient nor the health institutions. High RDW levels could be useful to predict in-hospital mortality in STEMI patients, as well as to give additional value to established risk scores such as the GRACE.