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
Authors: Sharma Rudrani , Agrawal V V 
Published: July 2015

<p><span style="font-family: Calibri;"><strong><span style="font-size: medium;">OBJECTIVES </span></strong><strong> </strong><span style="font-size: medium;">RDW CV</span><strong></strong><span style="font-size: medium;">is a marker of variation in size of rbc.</span><span style="font-size: medium;">RDW has been reported to be a predictor of cardiac events in CAD . </span><span style="font-size: medium;">CRP is a pentameric protein, an acute phase reactant and an independent marker of mortality in ACS .Here </span><span style="font-size: medium;"> </span><span style="font-size: medium;">we hypothesized that RDW CV level on admission and CRP would be predictive of adverse outcomes in NSTEMI and USAP</span><span style="font-size: medium;">  </span><span style="font-size: medium;">patients.</span></span></p><p><strong><span style="font-family: Calibri; font-size: medium;">METHODS</span></strong><span style="font-family: Calibri;"><span style="font-size: medium;">319 patients with ACS (240 males and</span><span style="font-size: medium;">  </span><span style="font-size: medium;">79 females) were prospectively analyzed. Patients were divided into two groups based on the fiftieth percentile of admission RDW levels.</span><span style="font-size: medium;">  </span><span style="font-size: medium;">High RDW group (n=214) was defined as those patients having RDW levels of &gt;14.0.Qualitative CRP positivity was observed in 113 patients.The relationship between RDW </span><span style="font-size: medium;"> </span><span style="font-size: medium;">and CRP and primary endpoint (cardiovascular deaths), secondary end points (reinfarction, repeat TVR) and MACE were assessed. The median follow-up was 6 months.</span></span></p><p><strong><span style="font-family: Calibri; font-size: medium;"> </span></strong></p><p><span style="font-family: Calibri;"><strong><span style="font-size: medium;">RESULTS </span></strong><span style="font-size: medium;"> </span><span style="font-size: medium;"> </span><span style="font-size: medium;">Patients in high RDW group were older (p=0.16), females with</span><span style="font-size: medium;">  </span><span style="font-size: medium;">history of HT diabetes and MI. They had higher admission creatinine , Killip class &gt;1 ,TIMI risk score,</span><span style="font-size: medium;">  </span><span style="font-size: medium;">CK-MB,</span><span style="font-size: medium;">  </span><span style="font-size: medium;">peak creatinine Ldl and TLC and lower lvef . They had more </span><span style="font-size: medium;"> </span><span style="font-size: medium;">killip&gt;1 (p=0.020) in hospital and at 6-months significantly increased mortality,reinfarction rates and hospitalization for heart failure was seen.</span><span style="font-size: medium;">Patients with positive crp and high rdw had</span><span style="font-size: medium;">  </span><span style="font-size: medium;">significantly increased adverse outcomes.</span></span></p><p><strong><span style="font-family: Calibri; font-size: medium;"> </span></strong></p><p><span style="font-family: Calibri;"><strong><span style="font-size: medium;">CONCLUSIONS</span></strong> <span style="font-size: medium;">Given the advantages of the RDW levels </span><span style="font-size: medium;"> </span><span style="font-size: medium;">it may be used as a marker of cardiovascular risk management in NSTEMI and USAP</span><span style="font-size: medium;">  </span><span style="font-size: medium;">along with crp and plan early invasive strategy.</span></span></p>