Abstract:Aim To explore the predictive value of combined detection of red blood cell distribution width (RDW) and N-terminal pro-brain natriuretic peptide (NT-proBNP) for acute kidney injury (AKI) after acute myocardial infarction (AMI). Methods A total of 110 patients with AMI admitted to Beijing Hospital of Integrated Traditional Chinese and Western Medicine from July 2018 to may 2020 were enrolled for retrospective study. Patients were divided into AKI group (n＝29) and non-AKI group (n＝81) according to whether AKI occurred within one week after admission.The levels of RDW and NT-proBNP in AKI group and non-AKI group were detected and compared. The clinical data of the two groups were collected, and the risk factors of AKI after AMI were analyzed by Logistic regression model. The correlation between RDW and NT-proBNP in AMI patients with AKI was analyzed by Pearson linear correlation analysis. The receiver operating characteristic curve (ROC) was drawn and the area under curve (AUC) was determined. The predictive value of RDW, NT-proBNP alone and combined detection for AKI after AMI was analyzed. Results The proportions of three vessel lesion and diuretic use in AKI group were 58.62% and 44.83% respectively, which were significantly higher than 27.16% and 18.52% in non-AKI group (P＜0.01). Uric acid (UA), blood urea nitrogen, serum creatinine, RDW and NT-proBNP levels in AKI group were significantly higher than those in non-AKI group, while estimated glomerular filtration rate (eGFR) was significantly lower than that in non-AKI group (P＜0.01). The results of Logistic regression model showed that the number of lesion, diuretic use and UA, eGFR, RDW, NT-proBNP were the risk factors of AKI in patients with AMI (P＜0.05). RDW was positively correlated with NT-proBNP (r＝0.693, P＜0.05). ROC curve analysis showed that the AUC of RDW, NT-proBNP alone and combined for prediction of AKI after AMI were 0.7,0.788 and 0.871, respectively. Conclusions The increase of RDW and NT-proBNP is closely related to the occurrence of AKI after AMI. The combined detection of RDW and NT-proBNP has high predictive value for the occurrence of AKI in patients with AMI.

Abstract:Aim To investigate the predictive value of red blood cell distribution width (RDW) for major adverse cardiac events (MACE) in patients with acute ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). Methods 243 clinical cases with acute STEMI after PCI was retrospectively studied. The incidence of MACE in all patients during hospitalization were carefully recorded. The predictive value of RDW for the incidence of MACE in patients with acute STEMI after PCI was analyzed by the receiver operating characteristic(ROC) curve of RDW levels. All the patients were divided into the high RDW group and the low RDW group according to the best cut-off point we determined. The differences of baseline data, laboratory data, coronary angiography, echocardiographic tissue Doppler imaging and the incidence of MACE were compared between the two groups. Results ROC curve showed that the area under the working characteristic curve of subjects with MACE predicted by RDW was 0.634 (95%CI:0.543～0.725,P＜0.05). When the optimal cut-off point of RDW levels was 13.35%, the sensitivity of predicting MACE was 52.5%, the specificity was 68%. The rate of MACE in the high RDW group(RDW≥13.35%) was higher than in the low RDW group(RDW＜13.35%)(24.42% vs 12.10%, P＜0.05). The multivariate Logistic regression analysis showed that the high RDW levels may be associated with MACE in acute STEMI patients after PCI treatment during hospitalization(OR=3.7,5%CI:1.275～7.093,P＜0.05). Conclusion RDW may be an independent risk factor for MACE in STEMI patients after PCI during hospitalization.

Abstract:Aim To investigate the distribution of red blood cell distribution width (RDW) and mean platelet volume (MPV) in patients with premature coronary artery disease(PCHD) and its relationship with the severity of PCHD, and to evaluate the diagnostic value of RDW and MPV for PCHD. Methods A total of 407 patients with suspected coronary artery disease(CHD) due to chest pain and male <55 years old and female <65 years old were enrolled in the study. All patients received coronary angiography (CAG), 309 cases of PCHD were confirmed and the remaining 98 cases were normal control group. The levels of RDW and MPV in the two groups and the subgroups of the PCHD were compared. The correlation between RDW and MPV and severity of coronary lesions (Gensini score) and independent risk factors for PCHD were analyzed. Results The levels of RDW and MPV in the PCHD group were significantly higher than those in the control group (P<0.05). RDW and MPV were higher in the acute myocardial infarction (AMI), unstable angina pectoris (UAP) and stable angina pectoris (SAP) groups than the control group (P<0.05); there was a positive correlation between RDW, MPV and Gensini scores in the PCHD group(r=0.246 and 0.199, P<0.05). Multivariate Logistic regression analysis showed that RDW and MPV were independent risk factors for PCHD(OR=3.3,5%CI:2.197~6.359, P<0.001; OR=1.3,5%CI:1.074~1.705, P=0.010). R0C curve analysis showed that the optimal cut-off value of RDW to diagnose PCHD was 12.25% with a sensitivity of 69% and specificity of 72%, and the optimal cut-off value of MPV to diagnose PCHD was 8.55 fl with a sensitivity of 91% and a specificity of 37%. Conclusions RDW and MPV are correlated to the clinical type of PCHD and the severity of PCHD. RDW and MPV are the independent risk factors for PCHD, which provides some value for the diagnosis of PCHD.

Abstract:Aim To explore the predictive value of red blood cell distribution width (RDW) for in-stent restenosis (ISR) after coronary stenting with drug-eluting stent (DES) in patients of type 2 diabetes. Methods The study retrospectively searched data at Tianjin Nankai Hospital for 582 unstable angina pectoris patients with type 2 diabetes who underwent PCI from January 2012 to December 2016. Among these patients, 292 patients with coronary DES implantation were enrolled in this study. The ISR was analyzed by coronary angiography analysis at a mean follow-up of eight months. According to whether ISR was detected, type 2 diabetes patients were divided into two groups:the ISR group (n=45) and the non-ISR group (n=247). Patients clinical and demographic characteristics were recorded including age, gender, smoking, anamnesis, RDW, C-reactive protein (CRP), cardiac ultrasound, coronary angiography, and so on. Results The body mass index (BMI) levels were higher in the ISR group than that in the non-ISR group (P<0.05). Patients with ISR had higher smoking rates (P<0.05). In addition, patients in the ISR group had significantly higher RDW levels compared with patients in the non-ISR group both at admission and at follow-up (P<0.01, respectively). Furthermore, the ISR group had significantly longer stent length and lower stent diameter compared with the non-ISR group (P<0.01, respectively). In an univariate model using RDW as a continuous variable, there was a significantly positive association between RDW levels and the incidence of ISR (P<0.01). Further multivariate logistic regression analysis revealed that BMI, smoking, RDW, CRP, stent length, and stent diameter were associated independently with ISR. Conclusion Elevated RDW has predictive value for ISR occurrence in type 2 diabetes patients with coronary DES implantation, which indicates that a chronic inflammatory response might be involved in the pathogenesis of ISR.

Abstract:Aim To study the relationship between arterial stiffness and red blood cell parameters. Methods304 patients were chosen in the Medical Center of the Southern District of Guanganmen Hospital of China Academy of Chinese Medical Sciences in July 2014. The medical history, measured height, weight, blood pressure, blood routine, biochemical indicators were asked, and Omron BP-203 RPE Ⅲ arterial stiffness detector was applied to test their arterial elasticity. According to brachial-ankle pulse wave velocity (baPWV), they were divided into normal group (n＝117 ), mild sclerosis group (n＝112) and atherosclerosis group (n＝75), and red blood cell parameters were compared among the three groups. Results The mean corpuscular volume (MCV) and red blood cell distribution width-correlation variance(RDW-CV) in the atherosclerosis group were significantly higher than that in the normal group (P<0.05 or P<0.01). The red blood cell distribution width-standard deviation (RDW-SD) in the atherosclerosis group was higher than that in the mild sclerosis group (P<0.05). The RDW-SD in the mild sclerosis group was higher than that in the normal group (P<0.05). Correlation analysis showed hemoglobin (HGB), hematocrit (HCT), MCV, mean corpuscular hemoglobin (MCH), RDW-CV, RDW-SD and baPWV were positively correlated. Multiple linear regression analysis showed the final regression equation included indicators was RDW-SD, HGB, the regression equation was baPWV＝-898.411＋39.657×RDW-SD＋3.171×HGB. Conclusion RDW-SD have a certain degree of clinical reference for the evaluation of atherosclerosis, while HGB is the impact factor of atherosclerosis.