The impact of complete blood count-derived indices (RDW, PDW and NLR) on 4 years outcomes in patients after PCI with sirolimus-eluting stent, including complex high-risk index procedure (CHIP) patients

Introduction: The authors analysed red cell distribution width (RDW), platelet distribution width (PDW), and the neutrophil-to-lymphocyte ratio (NLR) as potential predicting factors of adverse outcomes in patients after percutaneous coronary intervention (PCI) at 48 months follow-up. Material and methods: The authors gathered data on subjects who underwent PCI with a sirolimus-eluting Alex Plus stent (Balton, Poland). They characterized the rate of major adverse cardiovascular events (MACE) over a 4-year period, which encompassed cardiac death, myocardial infarction (MI), and target lesion revascularization (TLR) depending on the RDW, PDW, and NLR values. Results: Included were 218 patients (256 stents), among which were also identified 77 complex, high-risk index procedure (CHIP) patients and 73 high bleeding risk (HBR) patients. The authors identified only RDW as having a significant impact on long-term outcomes and only in the total population and CHIP patients. The total population with RDW > 14.5% was characterized by higher age (67 ± 11 vs. 73 ± 10 years, p < 0.01) and higher incidence of chronic kidney disease (14% vs. 39%, p < 0.01) as well as chronic obstructive pulmonary disease (4% vs. 15%, p = 0.024). Interestingly, this group had a lower rate of ACS (42% vs. 34%, p = 0.049). At 48 months in the total population with RDW > 14.5% of patients, the rates of MACE, cardiac death, MI, and TLR were 26.8%, 19.5%, 9.8%, and 12.2%, respectively. Conclusions: RDW > 14.5% correlated with a higher risk of cardiac death in the total population and CHIP patients.