Title: Raised Red Cell Distribution Width as a Risk Assessment Prognostic Tool For Post Myocardial Infarction Patients
Authors: Dr Akshay Surana (MD), Dr D. Maitra (MD)
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.223
Abstract
Objectives & Aims: The evaluation and identify new prognostic markers suggested in recent studies for coronary heart disease ,raised red blood cell distribution width (RDW) has been found to be associated with poor prognosis after resent myocardial infarction. Evaluate the relationship between raised RDW and mortality morbidity after the initial attack of myocardial infarction (MI). Increased red blood cell distribution width (RDW) has been associated with adverse outcomes. We studied the association between raised RDW during hospital course with clinical outcomes survival index of patients with after acute myocardial infarction (AMI).
Material & Methods: Blood was collected in a sterile EDTA containing tube and processed following our established iso certified hospital based laboratory protocol .A complete blood counting including HB%, PCV, Red cell indices ,platelet count, total white cell count and RDW was done by Automated blood cell counter. Level of Troponin I done by automated mini vidas bioanalyser.
Conclusion: we find significantly correlation in patients with post MI along with high RDW. RDW is an inexpensive cost effective and easily available laboratory test, high RDW with high troponin I for post MI have poor outcome of patients’ it could be used for mortality with morbidity risk assessment and follow up the patients after MI. we find that high RDW of raised troponin I pt. shows poor prognosis. confirmation of mi done by troponin I level of every patients.
Keyword: myocardial infarction, Red cell distribution width.
References
1. Buttarello M, Plebani M. Automated blood cell counts: state of the art. Am J Clin Pathol. 2008; 130:104-116. [PubMed]
2. Fritsma GA, Rodak KDBF. Hematology. Clinical Principles and applications. 20073rd edPhiladelphia: Saunders Elsevier
3. Nichols M, Townsend N, Scarborough P, Rayner M. Cardiovascular disease in Europe: epidemiological update. Eur Hear J. 2013; 34:3028-3034. [PubMed]
4. World Health Organization. The 10 leading causes of death in the world. 2011. Available from: http://who.int/mediacentre/factsheets/fs310/en/. Accessed May 31, 2014.
5. Zalawadiya SK, Veeranna V, Niraj A, Pradhan J, Afonso L. Red cell distribution width and risk of coronary heart disease events. Am J Cardiol. 2010; 106:988-993. [PubMed]
6. Dabbah S, Hammerman H, Markiewicz W, Aronson D. Relation between red cell distribution width and clinical outcomes after acute myocardial infarction. Am J Cardiol. 2010; 105:312-317. [PubMed]
7. Azab B, Torbey E, Hatoum H, Singh J, Khoueiry G, Bachir R, McGinn JT, Jr, McCord D, Laffert J.Usefulness of red cell distribution width in predicting all‐cause long‐term mortality after non‐ST‐elevation myocardial infarction. Cardiology. 2011; 119:72-80. [PubMed]
8. Lee JH, Yang DH, Jang SY, Choi WS, Kim KH, Lee WK, Bae MH, Park HS, Cho Y, Chae SC.Incremental predictive value of red cell distribution width for 12‐month clinical outcome after acute myocardial infarction. Clin Cardiol. 2013; 36:336-341. [PubMed]
9. Uyarel H, Ergelen M, Cicek G, Kaya MG, Ayhan E, Turkkan C, Yildirim E, Kirbas V, Onturk ET, Erer HB, Yesilcimen K, Gibson CM. Red cell distribution width as a novel prognostic marker in patients undergoing primary angioplasty for acute myocardial infarction. Coron Artery Dis. 2011; 22:138-144.[PubMed]
10. Pascual‐Figal DA, Bonaque JC, Redondo B, Caro C, Manzano‐Fernandez S, Sanchez‐Mas J, Garrido IP, Valdes M. Red blood cell distribution width predicts long‐term outcome regardless of anaemia status in acute heart failure patients. Eur J Heart Fail. 2009; 11:840-846. [PubMed]
11. Van Kimmenade RR, Mohammed AA, Uthamalingam S, van der Meer P, Felker GM, Januzzi JL., JrRed blood cell distribution width and 1‐year mortality in acute heart failure. Eur J Heart Fail. 2010; 12:129-136. [PubMed]
12. Allen LA, Felker GM, Mehra MR, Chiong JR, Dunlap SH, Ghali JK, Lenihan DJ, Oren RM, Wagoner LE, Schwartz TA, Adams KF., Jr Validation and potential mechanisms of red cell distribution width as a prognostic marker in heart failure. J Card Fail. 2010; 16:230-238. [PMC free article] [PubMed]
13. Patel KV, Ferrucci L, Ershler WB, Longo DL, Guralnik JM. Red blood cell distribution width and the risk of death in middle‐aged and older adults. Arch Intern Med. 2009; 169:515-523. [PMC free article][PubMed]
14. Perlstein TS, Weuve J, Pfeffer MA, Beckman JA. Red blood cell distribution width and mortality risk in a commu-nity‐based prospective cohort. Arch Intern Med. 2009; 169:588-594. [PMC free article] [PubMed]
15. Jacobsen BK, Eggen AE, Mathiesen EB, Wilsgaard T, Njolstad I. Cohort profile: the Tromso Study. Int J Epidemiol. 2012; 41:961-967. [PMC free article] [PubMed]
16. Braekkan SK, Hald EM, Mathiesen EB, Njolstad I, Wilsgaard T, Rosendaal FR, Hansen JB. Competing risk of atherosclerotic risk factors for arterial and venous thrombosis in a general population: the Tromso study. Arterioscler Thromb Vasc Biol. 2012; 32:487-491. [PubMed]
17. MORGAM Project. MORGAM manual. MORGAM Project ex2010publications. 2001. x2010; (1). URN:NBN:fix20-10fe20041529. Available from URL: http://www.thl.fi/publications/morgam/manual/followup/form22.htm. Accessed July 18, 2014.
18. World Health Organization. Nutritional anaemias. Report of a WHO scientific group. World Health Organ Tech Rep Ser. 1968; 405:5-37. [PubMed]
19. Arbel Y, Weitzman D, Raz R, Steinvil A, Zeltser D, Berliner S, Chodick C, Shalev V. Red blood cell distribution width and the risk of cardiovascular morbidity and all‐cause mortality. A population‐based study. Thromb Haemost. 2014; 111:300-307. [PubMed]
20. Chen PC, Sung FC, Chien KL, Hsu HC, Su TC, Lee YT. Red blood cell distribution width and risk of cardiovascular events and mortality in a community cohort in Taiwan. Am J Epidemiol. 2010; 171:214-220.[PubMed]
21. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med. 2005; 352:1011-1023. [PubMed]
22. Ghaffari S. Oxidative stress in the regulation of normal and neoplastic hematopoiesis. Antioxid Redox Signal. 2008; 10:1923-1940. [PMC free article] [PubMed]
23. Carnevali S, Petruzzelli S, Longoni B, Vanacore R, Barale R, Cipollini M, Scatena F, Paggiaro P, Celi A, Giuntini C. Cigarette smoke extract induces oxide-tive stress and apoptosis in human lung fibroblasts. Am J Physiol Lung Cell Mol Physiol. 2003; 284:L955-L963. [PubMed]
24. Kurtoğlu E, Aktürk E, Korkmaz H, Sincer I, Yilmaz M, Erdem K, Celik A, Ozdemir R. Elevated red blood cell distribution width in healthy smokers. Arch Turk Soc Cardiol. 2013; 43:199-206. [PubMed]
25. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med. 1997; 336:973-979. [PubMed]
26. Koenig W, Khuseyinova N, Baumert J, Meisinger C. Prospective study of high‐sensitivity C‐reactive protein as a determinant of mortality: results from the MONICA/KORA Augsburg Cohort Study, 1984–1998. Clin Chem. 2008; 54:335-342. [PubMed]
27. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009; 133:628-632. [PubMed]
28. Forhecz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohaszka Z, Janoskuti L. Red cell distribution width in heart failure: prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J. 2009; 158:659-666. [PubMed]
29. Sullivan JL. Iron and the sex difference in heart disease risk. Lancet. 1981; 1:1293-1294. [PubMed]
30. Munoz‐Bravo C, Gutiérrez‐Bedmar M, Gómez‐Aracena J, García‐Rodríguez A, Navajas JF. Iron: protector or risk factor for cardiovascular disease? Still controversial. Nutrients. 2013; 5:2384-2404. [PMC free article] [PubMed]
31. Krayenbuehl P‐A, Battegay E, Breymann C, Furrer J, Schulthess G. Intravenous iron for the treatment of fatigue in nonanemic, premenopausal women with low serum ferritin concentration. Blood. 2011; 118:3222-3227. [PubMed]
32. Patterson AJ, Brown WJ, Roberts DC. Dietary and supplement treatment of iron deficiency results in improvements in general health and fatigue in Australian women of childbearing age. J Am Coll Nutr. 2001;20:337-342. [PubMed]
33. Von Drygalski A, Adamson JW. Ironing out fatigue. Blood. 2011; 118:3191-3192. [PubMed]
34. Koskenkorva‐Frank TS, Weiss G, Koppenol WH, Burckhardt S. The complex interplay of iron metabolism, reactive oxygen species, and reactive nitrogen species: insights into the potential of various iron therapies to induce oxidative and nitrosative stress. Free Radic Biol Med. 2013; 65:1174-1194. [PubMed]
35. Lam AP, Gundabolu K, Sridharan A, Jain R, Msaouel P, Chrysofakis G, Yu Y, Friedman E, Price E, Schrier S, Verma AK. Multiplicative interaction between mean corpuscular volume and red cell distribution width in predicting mortality of elderly patients with and without anemia. Am J Hematol. 2013; 88:E245-E249. [PubMed]
36. Yeagle PL. Cholesterol and the cell membrane. Biochim Biophys Acta. 1985; 822:267-287. [PubMed]
37. Kolodgie FD, Gold HK, Burke AP, Fowler DR, Kruth HS, Weber DK, Farb A, Guerrero LJ, Hayase M, Kutys R, Narula J, Finn AV, Virmani R. Intraplaque hemorrhage and progression of coronary atheroma. N Engl J Med. 2003; 349:2316-2325. [PubMed]
38. Arbustini E, Morbini P, D'Armini AM, Repetto A, Minzioni G, Piovella F, Viganò M, Tavazzi L.Plaque composition in plexogenic and thromboembolic pulmonary hypertension: the critical role of thrombotic material in pultaceous core formation. Heart. 2002; 88:177-182. [PMC free article] [PubMed]
39. Kolodgie FD, Burke AP, Nakazawa G, Cheng Q, Xu X, Virmani R. Free cholesterol in atherosclerotic plaques: where does it come from? Curr Opin Lipidol. 2007; 18:500-507. [PubMed]