Multimedialna platforma wiedzy medycznej Internetowa Księgarnia Medyczna Kalendarium Konferencji
Medical Research Journal
MENU
Shortcuts Submit an article Author Guidelines Reviewers 2023 Focus and Scope

open access

Vol 8, No 2 (2023)
Original article
Published online: 2023-06-06
View PDF Download PDF file View HTML
Get Citation

The predictive value of complete blood count-derived indices for major adverse cardiovascular events in MINOCA patients at 5-year follow-up

Patryk Buller1, Adam Kern2, Maciej Tyczyński3, Wojciech Rosiak4, Wojciech Figatowski1, Robert J. Gil5, Jacek Bil3
DOI: 10.5603/MRJ.a2023.0023
·
Medical Research Journal 2023;8(2):128-134.
Affiliations
  1. Department of Cardiology, Provincial Integrated Hospital, Plock, Poland
  2. Department of Cardiology and Internal Medicine, University of Warmia and Mazury, Olsztyn, Poland
  3. Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Warsaw, Poland
  4. Department of Internal Medicine, Independent Public Complex of Healthcare Institutions, Zuromin, Poland
  5. Department of Cardiology, State Medical Institute of the Ministry of Interior, Warsaw, Poland

open access

Vol 8, No 2 (2023)
ORIGINAL ARTICLES
Published online: 2023-06-06

Abstract

Introduction: The authors analysed the potential of red blood cell and platelet indices such as red cell distribution width (RDW), mean corpuscular volume (MCV), and mean platelet volume (MPV) as predicting factors in myocardial infarction with non-obstructive coronary arteries (MINOCA) patients of 5-year outcomes.

Material and methods: Between 2010–2015 were identified 112 patients who had final MINOCA diagnosis and available laboratory findings. The primary endpoint was the 5-year major adverse cardiovascular events rate, defined as cardiac death, myocardial infarction, or hospitalization due to angina.

Results: Only RDW had a significant impact on long-term outcomes. 93 (83%) patients had RDW ≤ 14.5 (group 1), and 19 (17%) patients had RDW > 14.5 (group 2). The mean RDW value was 13.58 ± 1.11%. In group 1 and group 2, mean RDW values were 13.18 ± 0.55%, and 15.54 ± 1.06% (p < 0.001), respectively. Patients with abnormal RDW values (group 2) characterized lower value of left ventricular eject fraction (60 ± 8% vs. 53 ± 13%, p = 0.024), and higher NT-proBNP values (3,170 ± 5,285 pg/mL vs. 6,200 ± 4,223 pg/mL, p = 0.013) as well as troponin levels (501–2500 ng/mL: 31% vs. 53%, p = 0.02). A statistically significant difference was observed only for all-cause death. All-cause death rates for no RDW ≤ 14.5% vs. RDW > 14.5% were 2.2% vs. 21.1% (HR 5.09, 95% CI 1.03–25.2, p = 0.046), respectively.

Conclusions: RDW was significantly associated with the increased risk of all-cause mortality in MINOCA patients at 5 years.

Abstract

Introduction: The authors analysed the potential of red blood cell and platelet indices such as red cell distribution width (RDW), mean corpuscular volume (MCV), and mean platelet volume (MPV) as predicting factors in myocardial infarction with non-obstructive coronary arteries (MINOCA) patients of 5-year outcomes.

Material and methods: Between 2010–2015 were identified 112 patients who had final MINOCA diagnosis and available laboratory findings. The primary endpoint was the 5-year major adverse cardiovascular events rate, defined as cardiac death, myocardial infarction, or hospitalization due to angina.

Results: Only RDW had a significant impact on long-term outcomes. 93 (83%) patients had RDW ≤ 14.5 (group 1), and 19 (17%) patients had RDW > 14.5 (group 2). The mean RDW value was 13.58 ± 1.11%. In group 1 and group 2, mean RDW values were 13.18 ± 0.55%, and 15.54 ± 1.06% (p < 0.001), respectively. Patients with abnormal RDW values (group 2) characterized lower value of left ventricular eject fraction (60 ± 8% vs. 53 ± 13%, p = 0.024), and higher NT-proBNP values (3,170 ± 5,285 pg/mL vs. 6,200 ± 4,223 pg/mL, p = 0.013) as well as troponin levels (501–2500 ng/mL: 31% vs. 53%, p = 0.02). A statistically significant difference was observed only for all-cause death. All-cause death rates for no RDW ≤ 14.5% vs. RDW > 14.5% were 2.2% vs. 21.1% (HR 5.09, 95% CI 1.03–25.2, p = 0.046), respectively.

Conclusions: RDW was significantly associated with the increased risk of all-cause mortality in MINOCA patients at 5 years.

Full Text:

View PDF Download PDF file View HTML
Get Citation

Keywords

acetylcholine, chronic coronary syndrome, clinical outcomes, INOCA

About this article
Title

The predictive value of complete blood count-derived indices for major adverse cardiovascular events in MINOCA patients at 5-year follow-up

Journal

Medical Research Journal

Issue

Vol 8, No 2 (2023)

Article type

Original article

Pages

128-134

Published online

2023-06-06

Page views

1230

Article views/downloads

292

DOI

10.5603/MRJ.a2023.0023

Bibliographic record

Medical Research Journal 2023;8(2):128-134.

Keywords

acetylcholine
chronic coronary syndrome
clinical outcomes
INOCA

Authors

Patryk Buller
Adam Kern
Maciej Tyczyński
Wojciech Rosiak
Wojciech Figatowski
Robert J. Gil
Jacek Bil

References (38)
  1. Bil J, Pietraszek N, Pawlowski T, et al. Advances in mechanisms and treatment options of MINOCA caused by vasospasm or microcirculation dysfunction. Curr Pharm Des. 2018; 24(4): 517–531.
    CrossRefPubMed
  2. Yildiz M, Ashokprabhu N, Shewale A, et al. Myocardial infarction with non-obstructive coronary arteries (MINOCA). Front Cardiovasc Med. 2022; 9: 1032436.
    CrossRefPubMed
  3. Bossard M, Gao P, Boden W, et al. Antiplatelet therapy in patients with myocardial infarction without obstructive coronary artery disease. Heart. 2021; 107(21): 1739–1747.
    CrossRefPubMed
  4. Schmitz K, Groth N, Mullvain R, et al. Prevalence, clinical factors, and outcomes associated with myocardial infarction with nonobstructive coronary artery. Crit Pathw Cardiol. 2021; 20(2): 108–113.
    CrossRefPubMed
  5. Gasior P, Desperak A, Gierlotka M, et al. Clinical characteristics, treatments, and outcomes of patients with myocardial infarction with non-obstructive coronary arteries (MINOCA): results from a multicenter national registry. J Clin Med. 2020; 9(9).
    CrossRefPubMed
  6. Bil J, Kern A, Bujak K, et al. Clinical characteristics and 12-month outcomes in MINOCA patients before and during the COVID-19 pandemic. Pol Arch Intern Med. 2023 [Epub ahead of print].
    CrossRefPubMed
  7. Bil J, MoŻeŃska O, Segiet-ŚwiĘcicka A, et al. Revisiting the use of the provocative acetylcholine test in patients with chest pain and nonobstructive coronary arteries: A five-year follow-up of the AChPOL registry, with special focus on patients with MINOCA. Transl Res. 2021; 231: 64–75.
    CrossRefPubMed
  8. Dreyer RP, Tavella R, Curtis JP, et al. Myocardial infarction with non-obstructive coronary arteries as compared with myocardial infarction and obstructive coronary disease: outcomes in a Medicare population. Eur Heart J. 2020; 41(7): 870–878.
    CrossRefPubMed
  9. Lindahl B, Baron T, Erlinge D, et al. Medical therapy for secondary prevention and long-term outcome in patients with myocardial infarction with nonobstructive coronary artery disease. Circulation. 2017; 135(16): 1481–1489.
    CrossRefPubMed
  10. Gulati M, Khan N, George M, et al. Ischemia with no obstructive coronary artery disease (INOCA): A patient self-report quality of life survey from INOCA international. Int J Cardiol. 2023; 371: 28–39.
    CrossRefPubMed
  11. Arbel Y, Shacham Y, Finkelstein A, et al. Red blood cell distribution width (RDW) and long-term survival in patients with ST elevation myocardial infarction. Thromb Res. 2014; 134(5): 976–979.
    CrossRefPubMed
  12. Hou H, Sun T, Li C, et al. An overall and dose-response meta-analysis of red blood cell distribution width and CVD outcomes. Sci Rep. 2017; 7: 43420.
    CrossRefPubMed
  13. Su C, Liao LZ, Song Y, et al. The role of red blood cell distribution width in mortality and cardiovascular risk among patients with coronary artery diseases: a systematic review and meta-analysis. J Thorac Dis. 2014; 6(10): 1429–1440.
    CrossRefPubMed
  14. Kern A, Gil RJ, Bojko K, et al. Platelet distribution width as the prognostic marker in coronary bifurcation treatment. Eur J Clin Invest. 2017; 47(7): 524–530.
    CrossRefPubMed
  15. Sabe SA, Feng J, Sellke FW, et al. Mechanisms and clinical implications of endothelium-dependent vasomotor dysfunction in coronary microvasculature. Am J Physiol Heart Circ Physiol. 2022; 322(5): H819–H841.
    CrossRefPubMed
  16. Sucato V, Corrado E, Manno G, et al. Biomarkers of coronary microvascular dysfunction in patients with microvascular angina: a narrative review. Angiology. 2022; 73(5): 395–406.
    CrossRefPubMed
  17. Demirkol S, Balta S, Celik T, et al. Assessment of the relationship between red cell distribution width and cardiac syndrome X. Kardiol Pol. 2013; 71(5): 480–484.
    CrossRefPubMed
  18. Jung MH, Shin DIl, Choi IkJ, et al. Association between the red cell distribution width and vasospastic angina in Korean patients. Yonsei Med J. 2016; 57(3): 614–620.
    CrossRefPubMed
  19. Akpinar I, Sayin MR, Gursoy YC, et al. Plateletcrit and red cell distribution width are independent predictors of the slow coronary flow phenomenon. J Cardiol. 2014; 63(2): 112–118.
    CrossRefPubMed
  20. Lee MJ, Park SD, Kwon SW, et al. Relation between neutrophil-to-lymphocyte ratio and index of microcirculatory resistance in patients with st-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Am J Cardiol. 2016; 118(9): 1323–1328.
    CrossRefPubMed
  21. Bil J, Pietraszek N, Gil RJ, et al. Complete blood count-derived indices as prognostic factors of 5-year outcomes in patients with confirmed coronary microvascular spasm. Front Cardiovasc Med. 2022; 9: 933374.
    CrossRefPubMed
  22. Karakas MS, Korucuk N, Tosun V, et al. Red cell distribution width and neutrophil-to-lymphocyte ratio predict left ventricular dysfunction in acute anterior ST-segment elevation myocardial infarction. J Saudi Heart Assoc. 2016; 28(3): 152–158.
    CrossRefPubMed
  23. Uzun F, Guner A, Pusuroglu H, et al. Association of red blood cell distribution width, systemic-immune-inflammation index and poor cardiovascular outcomes in patients with newly diagnosed hypertension. Clin Exp Hypertens. 2022; 44(6): 530–538.
    CrossRefPubMed
  24. Li J, Gao W, Liu J, et al. Red blood cell distribution width and maximum left ventricular wall thickness predict poor outcomes in patients with hypertrophic cardiomyopathy. Echocardiography. 2022; 39(2): 278–285.
    CrossRefPubMed
  25. Duarte-Gamas L, Pereira-Neves A, Jácome F, et al. Red blood cell distribution width as a 5-year prognostic marker in patients submitted to carotid endarterectomy. Cerebrovasc Dis Extra. 2020 [Epub ahead of print]; 10(3): 181–192.
    CrossRefPubMed
  26. Martínez-Quintana E, Estupiñán-León H, Riaño-Ruiz M, et al. Red blood cell distribution width in addition to N-terminal prohormone of B-type natriuretic peptide concentration improves assessment of risk of cardiovascular events in adult patients with congenital heart disease. Arch Cardiovasc Dis. 2020; 113(10): 607–616.
    CrossRefPubMed
  27. Vieira-Cardoso N, Pereira-Neves A, Fragão-Marques M, et al. Red blood cell distribution width as a predictor of cardiovascular outcomes in extensive aortoiliac disease. J Cardiovasc Surg (Torino). 2023; 64(1): 48–57.
    CrossRefPubMed
  28. Dai C, Chen Z, Qian J, et al. Red cell distribution width as a marker of periprocedural myocardial infarction in patients with elective percutaneous coronary intervention. J Cardiovasc Transl Res. 2021; 14(3): 449–456.
    CrossRefPubMed
  29. Zhang B, Xu Y, Huang X, et al. Red blood cell distribution width: a risk factor for prognosis in patients with ischemic cardiomyopathy after percutaneous coronary intervention. J Clin Med. 2023; 12(4).
    CrossRefPubMed
  30. Wu TT, Zheng YY, Hou XG, et al. Red blood cell distribution width as long-term prognostic markers in patients with coronary artery disease undergoing percutaneous coronary intervention. Lipids Health Dis. 2019; 18(1): 140.
    CrossRefPubMed
  31. Xiao Q, Yan D, Qin J, et al. Dynamic changes in red cell distribution width can predict major adverse cardiovascular events after PCI in patients with unstable angina pectoris: a retrospective cohort study. Dis Markers. 2022; 2022: 2735717.
    CrossRefPubMed
  32. Markovic Bo, Brizic I, Mikulic I. The significance of red cell distribution width and homocysteine values in STEMI patients undergoing PCI in the population of Bosnia and Herzegovina. Eur Rev Med Pharmacol Sci. 2021; 25(10): 3791–3797.
    CrossRefPubMed
  33. Pan R. Relationship of red cell volume distribution width and n-terminal pro-brain natriuretic peptide with severity and prognosis of patients with acute coronary syndrome receiving percutaneous coronary intervention. Clin Lab. 2020; 66(4).
    CrossRefPubMed
  34. Machado GP, de Araujo GN, Carpes CK, et al. Long-term pattern of red cell distribution width in patients with st-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Crit Pathw Cardiol. 2020; 19(1): 43–48.
    CrossRefPubMed
  35. Turcato G, Serafini V, Dilda A, et al. Red blood cell distribution width independently predicts medium-term mortality and major adverse cardiac events after an acute coronary syndrome. Ann Transl Med. 2016; 4(13): 254.
    CrossRefPubMed
  36. Moriarty PM, Steg PG, McGinniss J, et al. ODYSSEY OUTCOMES Investigators. Relation of red blood cell distribution width to risk of major adverse cardiovascular events, death, and effect of alirocumab after acute coronary syndromes. J Clin Lipidol. 2022; 16: 747–756.
  37. Yucel H, Ozaydin M, Dogan A, et al. Evaluation of plasma oxidative status in patients with slow coronary flow. Kardiol Pol. 2013; 71(6): 588–594.
    CrossRefPubMed
  38. Buller P, Kern A, Tyczynski M, et al. Coronary slow flow is not an adverse prognostic factor in MINOCA patients in the 5-year follow-up. Med Res J (in press). 2023.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl