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Stent thrombosis is an uncommon but potentially fatal complication of percutaneous coronary interventions (PCI). In recent years, the predictive and prognostic value of the red cell distribution width (RDW), an indicator of inflammation, has been shown in several cardiovascular diseases. Aim of this study was to evaluate the predictive value of RDW on the development of stent thrombosis in patients undergoing successful stent implantation for acute ST-elevation myocardial infarction(MI) treatment.
We included 321 patients (mean age 55.3 ± 10.4 years, 86% male) who had undergone successful stent implantation for acute ST-elevation MI treatment and further control coronary angiography because of an acute coronary syndrome. Clinical, hematologic, and angiographic datas were analyzed.
Patients were divided into 3 tertiles according to the RDW values (12.9 ± 0.4, 14.2 ± 0.4 and 16.3 ± 1.5 respectively). Stent thrombosis developed in 47 (40.9%) patients in the lowest tertile, 39 (37.9%) patients in the middle tertile and 60 (58.3%) patients in the highest tertile (p=0.006). Female gender ratio was significantly high in the highest tertile (13 (11.3%), 8 (7.8%), 24 (23.3%), p=0.003, respectively). The RDW (odds ratio:1.397, 95% CI: 1.177- 1.657, p<0.001), platelet count (odds ratio:1.008, 95% CI: 1.004-1.012, p<0.001) remained independent predictors of stent thrombosis after multivariate logistic regression analysis. Receiver–operating characteristic (ROC) curve analysis demonstrated a cut off value 13.9 for the RDW, predicted the development of stent thrombosis with a sensitivity of 57% and specificity of 52% (Area under the ROC curve: 0.59, 95% CI: 0.53 to 0.65, p=0.007).
High RDW values were found to be independently associated with the development of stent thrombosis in patients with ST-elevation MI.