The Relationship Between Red Blood Cell Distribution Width (RDW CV) And C Reactive Protein (CRP) With The Clinical Outcomes In Non-St Elevation Myocardial Infarction And Unstable Angina Pectoris: A 6 Months Follow Up Study
OBJECTIVES RDW CVis a marker of variation in size of rbc.RDW has been reported to be a predictor of cardiac events in CAD . CRP is a pentameric protein, an acute phase reactant and an independent marker of mortality in ACS .Here we hypothesized that RDW CV level on admission and CRP would be predictive of adverse outcomes in NSTEMI and USAP patients.
METHODS319 patients with ACS (240 males and 79 females) were prospectively analyzed. Patients were divided into two groups based on the fiftieth percentile of admission RDW levels. High RDW group (n=214) was defined as those patients having RDW levels of >14.0.Qualitative CRP positivity was observed in 113 patients.The relationship between RDW and CRP and primary endpoint (cardiovascular deaths), secondary end points (reinfarction, repeat TVR) and MACE were assessed. The median follow-up was 6 months.
RESULTS Patients in high RDW group were older (p=0.16), females with history of HT diabetes and MI. They had higher admission creatinine , Killip class >1 ,TIMI risk score, CK-MB, peak creatinine Ldl and TLC and lower lvef . They had more killip>1 (p=0.020) in hospital and at 6-months significantly increased mortality,reinfarction rates and hospitalization for heart failure was seen.Patients with positive crp and high rdw had significantly increased adverse outcomes.
CONCLUSIONS Given the advantages of the RDW levels it may be used as a marker of cardiovascular risk management in NSTEMI and USAP along with crp and plan early invasive strategy.
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