Red Cell Distribution Width as a Marker of Disease Severity and In-hospital Mortality in Patients with ST-segment Elevation Myocardial Infarction

Background:The red cell distribution width (RDW) has been investigated as a predictive factor for complications and mortality in several critical illnesses, including cardiovascular diseases. Objective: The current study aimed to assess the relationship of RDW with severity and in-hospital mortality in patients with ST-elevation myocardial infarction (STEMI). Materials and methods: A prospective hospital-based observational study was conducted at a tertiary care institute of Northern India. Fifty patients of STEMI who underwent coronary angiography/primary coronary intervention were enrolled as cases and equal number of age- and sex-matched individuals not suffering from any cardiac disease were taken as controls. The RDW admission values of the cases were compared with that of controls. Red cell distribution width values were also compared across the outcome groups among cases. Results: The mean RDW-SD of the cases was 49.0 +/- 4.6 fL whereas it was 44.7 +/- 3.5 fL for controls, the difference being statistically significant (p < 0.001). Among the total patients, 4 (8.0%) expired during hospital stay and the rest 46 (92.0%) were discharged alive. The mean RDW-SD of expired patients was significantly higher than that of patients who remained alive (p = 0.002). There was a significant positive correlation between RDW and global registry of acute coronary events (GRACE) score (p = 0.02) and a significant negative correlation between RDW and left ventricular ejection fraction (LVEF) (p = 0.04). Area under the receiver operating characteristics (ROC) curve for RDW was higher than that of LVEF, showing superiority of RDW to LVEF in predicting mortality among the STEMI patients. Conclusion: Red cell distribution width may serve as a promising prognostic biomarker and tool for risk stratification in patients with STEMI.