Key result
Higher RDW linked to ~168% higher odds of no-reflow in diabetic STEMI undergoing PCI.
Why the study?
No-reflow phenomenon in STEMI patients is not infrequent, and the predictive value of RDW on NRP had not been explored.
Does admission RDW predict the no-reflow phenomenon in STEMI patients with and without diabetes mellitus undergoing primary PCI?
Cohort (n=778)
No
Does admission RDW predict the no-reflow phenomenon in STEMI patients with and without diabetes mellitus undergoing primary PCI?
Admission RDW is an independent predictor of the no-reflow phenomenon in STEMI patients with diabetes undergoing primary PCI, but not in those without diabetes.
Admission RDW was associated with no-reflow after primary PCI in diabetic STEMI; leaves open whether RDW informs risk stratification or interventions.
Background: No-reflow phenomenon (NRP) in ST-segment elevation myocardial infarction (STEMI) patients is not infrequent. The predictive value of red blood-cell distribution width (RDW) on NRP has not been explored. Methods: STEMI patients undergoing primary percutaneous coronary intervention (pPCI) were enrolled. Plasma samples were obtained at admission. Participants were divided into two groups according to RDW. Logistic regression and receiver operating characteristic (ROC) curve were performed to evaluate the relationship between RDW and NRP. Subgroup analysis was made between the diabetes mellitus (DM) group and the No-DM group. Results: The high RDW group had a higher NRP compared to the low group. In multivariate logistic regression analysis, DM (adjusted odds ratio [AOR]:1.847; 95% confidence interval [CI]: 1.209–2.822; p = 0.005) and hemoglobin (AOR: 0.986; 95% CI: 0.973–0.999; p < 0.05), other than RDW, were independent predictors of NRP. RDW (AOR: 2.679; 95% CI: 1.542–4.655; p < 0.001) was an independent predictor of NRP in the DM group, but not in the No-DM group. In the DM group, area under the ROC curve value for RDW predicting NRP was 0.707 (77.3% sensitivity, 56.3% specificity (p < 0.001)). Conclusions: RDW is a predictor of NRP in DM patients with STEMI, which provides further assistance in clinicians’ decision making.
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Sun et al. (2023) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=778). Red blood-cell distribution width (RDW) vs. Low RDW was evaluated on No-reflow phenomenon (NRP) (AOR 2.679, 95% CI 1.542-4.655, p=<0.001). In patients with diabetes mellitus and ST-segment elevation myocardial infarction undergoing primary PCI, higher red blood-cell distribution width was an independent predictor of the no-reflow phenomenon (AOR 2.679).
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