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Heshmat-Ghahdarijani K, Fakhrolmobasheri M. Is Red Cell Distribution Width a Reliable Marker for Cardiovascular Diseases? A Narrative Review. Cardiol Rev 2024; 32:362-370. [PMID: 36730493 DOI: 10.1097/crd.0000000000000500] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Red cell distribution width (RDW) is an easy-to-access marker which is routinely measured in complete blood count (CBC) test. Besides the classic use of RDW as a marker for discriminating different types of anemia, recent studies had indicated the relationship between high RDW and cardiovascular diseases. High RDW is not only useful in the diagnosis and prognostication of various cardiovascular conditions but also could be used as a valuable tool for predicting the incidence of cardiovascular diseases. population-based studies have indicated that higher RDW could effectively predict the incidence of heart failure (HF), atherosclerotic diseases, and atrial fibrillation (AF). It has been also demonstrated that higher RDW is associated with worse outcomes in these diseases. Recent studies have shown that high RDW is also associated with other cardiovascular conditions including cardiomyopathies, and pulmonary hypertension. The predictive role of RDW in endovascular interventions has also been demonstrated by many recent studies. Here in this review, we attempt to compile the most recent findings with older reports regarding the relation between high RDW and HF, cardiomyopathies, pulmonary hypertension, AF, atherosclerotic disorders, primary hypertension, and the outcomes of endovascular interventions. we also discussed the role of RDW in the prognostication of different cardiovascular conditions when combined with classic classification criteria.
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Affiliation(s)
- Kiyan Heshmat-Ghahdarijani
- From the Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Fakhrolmobasheri
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Budzianowski J, Faron W, Rzeźniczak J, Słomczyński M, Hiczkiewicz D, Olejniczak J, Hiczkiewicz J, Burchardt P. Predictors of Revascularization in Patients with Unstable Angina. J Clin Med 2024; 13:1096. [PMID: 38398410 PMCID: PMC10889168 DOI: 10.3390/jcm13041096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/06/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The factors that determine the necessity of coronary artery revascularization in patients with unstable angina (UA) have been supported by limited data. Therefore, this study aimed to identify the predictors of revascularization in patients with UA. METHODS The study included the recorded data of 3668 patients with UA who underwent cardiac catheterization (age 66 ± 9.2, men 70%); 2615 of them (71%) underwent revascularization (percutaneous transluminal coronary angioplasty (PTCA), coronary artery bypass graft (CABG), or hybrid revascularization. The remaining 1053 patients (29%) had no significant coronary stenosis and were regarded as controls. Multivariable logistic regression analysis was performed to separate the predictors of revascularization. RESULTS It was found that severe angina (OR 2.7, 95%CI 1.9-3.7), male gender (OR 1.4, 95%CI 1.1-1.7), and hyperlipidemia were the predictors of revascularization. It was also noted that intraventricular conduction disorders including left and right bundle branch blocks and a history of previous revascularization and myocardial infarction were associated with lower odds of revascularization. CONCLUSION Overall, however, the predictive value of the studied factors proved to be poor and may still point to the multifactorial nature of significant coronary artery stenosis and the need for revascularization in patients with UA.
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Affiliation(s)
- Jan Budzianowski
- “Club 30”, Polish Cardiac Society, 93-338 Łódź, Poland;
- Department of Interventional Cardiology and Cardiac Surgery, Collegium Medicum, University of Zielona Góra, 65-046 Zielona Góra, Poland; (D.H.); (J.H.)
- Department of Cardiology, Nowa Sól Multidisciplinary Hospital, 67-100 Nowa Sól, Poland;
| | - Wojciech Faron
- Department of Cardiology, Nowa Sól Multidisciplinary Hospital, 67-100 Nowa Sól, Poland;
| | - Janusz Rzeźniczak
- Department of Cardiology, J. Strus Hospital, 61-285 Poznań, Poland; (J.R.); (M.S.)
| | - Marek Słomczyński
- Department of Cardiology, J. Strus Hospital, 61-285 Poznań, Poland; (J.R.); (M.S.)
| | - Dariusz Hiczkiewicz
- Department of Interventional Cardiology and Cardiac Surgery, Collegium Medicum, University of Zielona Góra, 65-046 Zielona Góra, Poland; (D.H.); (J.H.)
- Department of Cardiology, Nowa Sól Multidisciplinary Hospital, 67-100 Nowa Sól, Poland;
| | | | - Jarosław Hiczkiewicz
- Department of Interventional Cardiology and Cardiac Surgery, Collegium Medicum, University of Zielona Góra, 65-046 Zielona Góra, Poland; (D.H.); (J.H.)
- Department of Cardiology, Nowa Sól Multidisciplinary Hospital, 67-100 Nowa Sól, Poland;
| | - Paweł Burchardt
- “Club 30”, Polish Cardiac Society, 93-338 Łódź, Poland;
- Department of Cardiology, J. Strus Hospital, 61-285 Poznań, Poland; (J.R.); (M.S.)
- Department of Hypertension, Angiology, and Internal Medicine, Poznan University of Medical Sciences, 61-848 Poznań, Poland
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Wu L, Zhang J, Zhang HM, Wang CY. Study on red blood cell distribution width in children with severe Mycoplasma pneumoniae pneumonia. Biomark Med 2024; 18:69-77. [PMID: 38440878 DOI: 10.2217/bmm-2023-0671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
Background: This study aimed to investigate the clinical value of the red blood cell distribution width (RDW) in severe Mycoplasma pneumoniae pneumonia (MPP). Methods: A total of 185 children with diagnosed severe MPP were included. The patients' case records and laboratory examination data were analyzed retrospectively. The children were grouped into quartiles based on RDW. Results: Univariate analysis revealed that RDW was significantly correlated with the Pediatric Risk of Mortality (PRISM) III score, Sepsis-Related Organ Failure Assessment score, incidence of invasive intubation and 30-day in-hospital mortality. After adjustment for the severity of illness, multivariate analysis revealed that the PRISM III score and RDW were factors independently associated with 30-day in-hospital mortality. Conclusion: This study revealed that RDW could be correlated with the long-term prognosis and severity of severe MPP.
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Affiliation(s)
- Lin Wu
- Department of Pediatrics, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
- Department of Pediatrics, Fujian Maternity and Children Hospital, College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
| | - Jinyan Zhang
- College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
| | - Hui-Min Zhang
- Department of Pediatrics, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
| | - Cheng-Yi Wang
- Department of Pediatrics, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
- Department of Pediatrics, Fujian Maternity and Children Hospital, College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
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Pan T, Tian SY, Xiong SS, Ji DH, Liu Z, Wang F. Anemia as a risk factor for restenosis in femoropopliteal arterial disease after drug-coated balloon angioplasty. Vascular 2023; 31:948-953. [PMID: 35499107 DOI: 10.1177/17085381221098289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study aimed to investigate the relationship between anemia and restenosis in patients with femoropopliteal arterial disease following drug-coated balloon (DCB) angioplasty. METHODS 194 patients treated with DCB for femoropopliteal lesions were retrospectively analyzed for up to 12 months of follow-up between January 2017 and September 2020. Baseline clinical and procedural characteristics were compared between the anemia and non-anemia patients, and predictors of restenosis were identified using logistic regression. RESULTS 32.5% of the patients undergoing DCB angioplasty had anemia. Patients with anemia were significantly older, with higher rates of hypertension, coronary artery disease, chronic renal insufficiency, and diabetes, and with lower rates of smoking and male gender. In the multivariate analysis, anemia was independently and significantly associated with a higher risk of restenosis (OR, 3.872; 95% CI, 1.556-9.638; P = 0.004). CONCLUSION Anemia is independently associated with restenosis in patients treated with DCB for femoropopliteal arterial disease. Patients with lower baseline hemoglobin might have more chances to develop restenosis at follow-up.
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Affiliation(s)
- Tao Pan
- The Interventional Therapy department of the first Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shi-Yun Tian
- Department of radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shan-Shan Xiong
- The Interventional Therapy department of the first Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Dong-Hua Ji
- The Interventional Therapy department of the first Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Zhen Liu
- The Interventional Therapy department of the first Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Feng Wang
- The Interventional Therapy department of the first Affiliated Hospital of Dalian Medical University, Dalian, China
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Jiang M, Shen J, Muhammad B, Geng D. Red blood cell distribution width to platelet ratio predicts early neurological deterioration in acute ischemic stroke patients receiving intravenous thrombolysis. J Stroke Cerebrovasc Dis 2023; 32:107146. [PMID: 37148627 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107146] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/09/2023] [Accepted: 04/18/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Inflammation plays a prominent role in the pathogenesis and progression of acute ischemic stroke (AIS). The red blood cell distribution width to platelet ratio (RPR) has been demonstrated as a novel biomarker to indicate the severity of inflammatory reaction. This study aimed to explore the association between RPR before intravenous thrombolysis and early neurological deterioration (END) after thrombolysis in AIS patients. METHODS AIS patients accepting intravenous thrombolysis were recruited continuously. Postthrombolysis END was defined as death or an increase in the National Institute of Health Stroke Scale (NIHSS) score ≥4 points within 24 h after intravenous thrombolysis compared to the NIHSS score before intravenous thrombolysis. We constructed univariate and multivariate logistic regression analyses to investigate the relationship of RPR before intravenous thrombolysis to postthrombolysis END. Moreover, a receiver operating characteristic (ROC) curve was applied to examine the discriminative utility of RPR before intravenous thrombolysis in predicting postthrombolysis END. RESULTS A total of 235 AIS patients were included, and 31 (13.19%) subjects underwent postthrombolysis END. The univariate logistic regression analysis demonstrated that RPR before intravenous thrombolysis was significantly related to postthrombolysis END (odds ratio [OR], 2.162; 95% confidence interval [CI], 1.605-2.912; P < 0.001). After adjusting for potential confounding variables with P < 0.15 in the univariate logistic regression analysis, the difference remained statistically significant (OR, 2.031; 95% CI, 1.436-2.873; P < 0.001). Furthermore, an optimal cutoff value of 7.66 for RPR before intravenous thrombolysis in predicting postthrombolysis END was observed in the ROC curve analysis, and the sensitivity and specificity were calculated as 61.3% and 81.9%, respectively (area under the curve [AUC], 0.772; 95% CI, 0.684-0.860; P < 0.001). CONCLUSIONS RPR before intravenous thrombolysis might be an independent risk factor for postthrombolysis END in AIS patients. Elevated levels of RPR before intravenous thrombolysis may predict postthrombolysis END.
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Affiliation(s)
- Min Jiang
- The First School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, China; Department of Neurology, The Affiliated Huai'an Hospital of Xuzhou Medical University and The Second People's Hospital of Huai'an, Huai'an, Jiangsu 223002, China
| | - Jun Shen
- Department of Neurology, The Affiliated Huai'an Hospital of Xuzhou Medical University and The Second People's Hospital of Huai'an, Huai'an, Jiangsu 223002, China
| | - Bilal Muhammad
- School of Graduate, Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
| | - Deqin Geng
- The First School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, China; Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China.
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Qin B, Li Z, Zhou H, Liu Y, Wu H, Wang Z. The Predictive Value of the Perivascular Adipose Tissue CT Fat Attenuation Index for Coronary In-stent Restenosis. Front Cardiovasc Med 2022; 9:822308. [PMID: 35557525 PMCID: PMC9088879 DOI: 10.3389/fcvm.2022.822308] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 04/04/2022] [Indexed: 12/27/2022] Open
Abstract
Objectives To investigate the association between the perivascular adipose tissue (PVAT) fat attenuation index (FAI) derived from coronary computed tomography angiography (CCTA) and the prevalence of in-stent restenosis (ISR) in patients with coronary stent implantation. Methods A total of 117 patients with previous coronary stenting referred for invasive coronary angiography (ICA) were enrolled in this retrospective observational analysis. All patients underwent CCTA between July 2016 and November 2021. The deep learning-based (DL-based) method was used to analyze and measure the peri-stent FAI value. Additionally, the relationship between hematological and biochemical parameters collected from all the patients was also explored. The least absolute shrinkage and selection operator (LASSO) method was applied to the most useful feature selection, and binary logistic regression was used to test the association between the selected features and ISR. The predictive performance for ISR of the identified subgroups was evaluated by calculating the area under the curve (AUC) of receiver operator curves plotted for each model. The Pearson correlation coefficient was used to assess the correlation of peri-stent FAI values with degrees of ISR. Results The peri-stent FAI values in the ISR group were significantly higher than those in the non-ISR group (−78.1 ± 6.2 HU vs. −87.2 ± 7.3 HU, p < 0.001). The predictive ISR features based on the LASSO analysis were peri-stent FAI, high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (ApoA1), and high-sensitivity c-reactive protein (hs-CRP), with an AUC of 0.849, 0.632, 0.620, and 0.569, respectively. Binary logistic regression analysis determined that peri-stent FAI was uniquely and independently associated with ISR after adjusting for other risk factors (odds ratio [OR] 1.403; 95% CI: 1.211 to 1.625; p < 0.001). In the subgroup analysis, the AUCs of the left anterior descending coronary artery (LAD), left circumflex coronary artery (LCx), and right coronary artery (RCA) stents groups were 0.80, 0.87, and 0.96, respectively. The Pearson's correlation coefficient indicated a term moderately correlation between ISR severity and peri-stent FAI values (r = 0.579, P < 0.001). Conclusions The peri-stent FAI can be used as an independently non-invasive biomarker to predict ISR risk and severity after stent implantation.
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Affiliation(s)
- Bin Qin
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhengjun Li
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Hao Zhou
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yongkang Liu
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Huiming Wu
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhongqiu Wang
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Zhou J, Chai D, Dai Y, Wang A, Yan T, Lu S. Predictive Value Analysis of in-Stent Restenosis Within Three Years in Older Acute Coronary Syndrome Patients: A Two-Center Retrospective Study. Clin Appl Thromb Hemost 2022; 28:10760296221107888. [PMID: 35706375 PMCID: PMC9208031 DOI: 10.1177/10760296221107888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We aimed to investigate prognostic factors of in-stent restenosis (ISR) within 3 years in older acute coronary syndrome (ACS) patients after drug-eluting stent (DES) implantation and establish a clinical model for predicting ISR. We retrospectively collected 215 older ACS patients who followed coronary angiography (CAG) after DES implantation, divided into ISR group and non in-stent restenosis (non-ISR) group according to the results of reviewed CAG. Logistic regression analysis was performed to screen independent predictors related to ISR and build the clinical predictive model, which clinical application was assessed by decision curve analysis (DCA) and clinical impact curve (CIC). Kaplan-Meier survival curves for ISR by independent predictors. In multivariate logistic regression analysis showed that the red cell distribution width (RDW) was higher in ISR group compared with non-ISR (odds ratio (OR) = 1.54, 95% confidence interval (CI): 1.14–2.08, p < 0.01). Instead, a negative correlation was observed between minimum stent diameter and ISR (OR = 0.28, 95%CI:0.09-0.86, p = 0.03). A novel nomogram composed of these significant features presented a concordance index (C-index) of 0.710, DCA and CIC suggested that the predictive nomogram had clinical utility. Schoenfeld residuals showed the model RDW ≥ 12.6% with minimum stent diameter <3 mm was consistent with the proportional risk assumption. The Kaplan-Meier estimate for ISR showed statistical significance. Higher levels of RDW and lower minimum stent diameter were associated with incidence of ISR within 3 years in older ACS patients after DES implantation.
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Affiliation(s)
- Jing Zhou
- Department of Cardiology, 442535The First People's Hospital of Taicang, The Affiliated Taicang Hospital of Soochow University, Taicang, China
| | - Dayang Chai
- Department of Cardiology, 442535The First People's Hospital of Taicang, The Affiliated Taicang Hospital of Soochow University, Taicang, China
| | - Yuxiang Dai
- Department of Cardiology, 92323Zhongshan Hospital Affiliated of Fudan University, Shanghai, China
| | - Aichao Wang
- Department of Cardiology, 442535The First People's Hospital of Taicang, The Affiliated Taicang Hospital of Soochow University, Taicang, China
| | - Ting Yan
- Department of Dermatology, 442535The First People's Hospital of Taicang, The Affiliated Taicang Hospital of Soochow University, Taicang, China
| | - Shu Lu
- Department of Cardiology, 442535The First People's Hospital of Taicang, The Affiliated Taicang Hospital of Soochow University, Taicang, China
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Hu H, Wang S, Tang G, Zhai C, Shen L. Impact of anemia on in-stent restenosis after percutaneous coronary intervention. BMC Cardiovasc Disord 2021; 21:548. [PMID: 34798833 PMCID: PMC8603472 DOI: 10.1186/s12872-021-02355-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/29/2021] [Indexed: 12/18/2022] Open
Abstract
Background Anemia is a common risk factor for post-percutaneous coronary intervention (PCI) adverse events; however, data on its association with in-stent restenosis (ISR) is limited. Methods 538 patients who underwent PCI between January 2017 and September 2019 and follow-up angiography 9–12 months after the initial PCI were enrolled in this study. Baseline clinical and procedural characteristics were compared between the ISR and non-ISR groups, and independent predictors of ISR were determined using propensity score matching. Results The incidence of anemia was 53.5% in patients with ISR and 19.0% in those without ISR. Univariable logistic regression analyses showed that anemia (OR, 4.283; 95% CI, 1.949–9.410; P < 0.001), diabetes mellitus (OR, 2.588; 95% CI, 1.176–5.696; P = 0.018), chronic kidney disease (OR, 3.058; 95% CI, 1.289–7.252; P = 0.011), multiple stenting (OR, 2.592; 95% CI, 1.205–5.573; P = 0.015), bifurcation lesion (OR, 2.669; 95% CI, 1.236–5.763; P = 0.012), and calcification (OR, 3.529; 95% CI, 1.131–11.014; P = 0.030) were closely associated with ISR. Low-density lipoprotein cholesterol (LDL-c) levels and stent diameter were also significantly linked to ISR, as was anemia (P = 0.009) after propensity score matching. Conclusion Anemia is closely associated with post-PCI ISR, and patients with lower hemoglobin levels are at a higher risk of ISR.
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Affiliation(s)
- Huilin Hu
- Department of Cardiology, Affiliated Hospital of Jiaxing University, No.1882 Zhonghuan South Road, Jiaxing, Zhejiang, China
| | - Shijun Wang
- Department of Cardiology, Affiliated Hospital of Jiaxing University, No.1882 Zhonghuan South Road, Jiaxing, Zhejiang, China
| | - Guanmin Tang
- Department of Cardiology, Affiliated Hospital of Jiaxing University, No.1882 Zhonghuan South Road, Jiaxing, Zhejiang, China
| | - Changlin Zhai
- Department of Cardiology, Affiliated Hospital of Jiaxing University, No.1882 Zhonghuan South Road, Jiaxing, Zhejiang, China
| | - Liang Shen
- Department of Cardiology, Affiliated Hospital of Jiaxing University, No.1882 Zhonghuan South Road, Jiaxing, Zhejiang, China.
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Hussein A, Awad MS, Sabra AM, Mahmoud HEM. Anemia is a novel predictor for clinical ISR following PCI. Egypt Heart J 2021; 73:40. [PMID: 33932182 PMCID: PMC8088416 DOI: 10.1186/s43044-021-00163-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/16/2021] [Indexed: 11/26/2022] Open
Abstract
Background Conflicting data were found regarding the anemia’s effect on percutaneous coronary intervention (PCI) outcomes. We directed our study to investigate anemia’s effect on clinical in-stent restenosis (ISR) following PCI. Results A prospective multi-center cohort study was performed on 470 consecutive participants undergoing elective PCI. We classified the participants into two groups: group 1 who were anemic and group 2 who were non-anemic as a control group. At 1, 3, 6, and 12 months by clinic visits, we followed up with the patients to assess anemia’s clinical ISR effect. We found that 20% of the patients undergoing PCI had anemia. Anemic patients showed a statistically significant higher rate of impaired renal function and diabetes and a higher percentage of the female gender. Multivariate regression analysis for major adverse cardiovascular events (MACEs) after adjusting for confounding factors revealed that anemia represents a more risk on MACE (adjusted hazard ratio (HR) was 4.13; 95% CI 2.35–7.94; p value < 0.001) and carries a higher risk upon clinical ISR (adjusted HR was 3.51; 95% CI 1.88–7.16; p value < 0.001) over 12 months of follow-up. Conclusion Anemic patients going through PCI are generally females, diabetics, and have renal impairment. Anemia might be considered another indicator for clinical ISR and is fundamentally associated with an increased MACE incidence.
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Affiliation(s)
- Ahmed Hussein
- Department of Internal Medicine, Faculty of Medicine, Sohag University, Nasser City, Sohag, 82524, Egypt.
| | - Mohammad Shafiq Awad
- Department of Cardiology, Faculty of Medicine, Beni Suef University, Beni Suef City, 62511, Egypt
| | - Ahlam M Sabra
- Department of Internal Medicine, Faculty of Medicine, South Valley University, Qena City, Qena, 83511, Egypt
| | - Hossam Eldin M Mahmoud
- Department of Internal Medicine, Faculty of Medicine, South Valley University, Qena City, Qena, 83511, Egypt
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Lazzeroni D, Moderato L, Marazzi PL, Pellegrino C, Musiari E, Castiglioni P, Camaiora U, Bini M, Geroldi S, Brambilla L, Brambilla V, Coruzzi P. Red blood cell distribution width as a novel prognostic marker after myocardial revascularization or cardiac valve surgery. Sci Rep 2021; 11:7889. [PMID: 33846483 PMCID: PMC8041885 DOI: 10.1038/s41598-021-87075-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 02/02/2021] [Indexed: 01/12/2023] Open
Abstract
The red blood cell distribution width (RDW) measures the variability in the size of circulating erythrocytes. Previous studies suggested a powerful correlation between RDW obtained from a standard complete blood count and cardiovascular diseases in both primary and secondary cardiovascular prevention. The current study aimed to evaluate the prognostic role of RDW in patients undergoing cardiac rehabilitation after myocardial revascularization and/or cardiac valve surgery. The study included 1.031 patients with available RDW levels, prospectively followed for a mean of 4.5 ± 3.5 years. The mean age was 68 ± 12 years, the mean RDW was 14.7 ± 1.8%; 492 patients (48%) underwent cardiac rehabilitation after myocardial revascularization, 371 (36%) after cardiac valve surgery, 102 (10%) after valve-plus-coronary artery by-pass graft surgery, 66 (6%) for other indications. Kaplan-Meier analysis and Cox hazard analysis were used to associate RDW with mortality. Kaplan-Meier analysis demonstrated worse survival curves free from overall (log-rank p < 0.0001) and cardiovascular (log-rank p < 0.0001) mortality in the highest RDW tertile. Cox analysis showed RDW levels correlated significantly with the probability of overall (HR 1.26; 95% CI 1.19-1.32; p < 0.001) and cardiovascular (HR 1.31; 95% CI 1.23-1.40; p < 0.001) mortality. After multiple adjustments for cardiovascular risk factors, hemoglobin, hematocrit, C-reactive protein, microalbuminuria, atrial fibrillation, glomerular filtration rate,left ventricular ejection fraction and number of exercise training sessions attended, the increased risk of overall (HR 1.10; 95% CI 1.01-1.27; p = 0.039) and cardiovascular (HR 1.13; 95% CI 1.01-1.34; p = 0.036)mortality with increasing RDW values remained significant. The RDW represents an independent predictor of overall and cardiovascular mortality in secondary cardiovascular prevention patients undergoing cardiac rehabilitation.
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Affiliation(s)
- Davide Lazzeroni
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
- , Piazzale dei Servi, n°3, 43121, Parma, Italy.
| | | | | | | | | | | | | | | | | | | | | | - Paolo Coruzzi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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Filatova AY, Shlevkova GV, Potekhina AV, Osokina AK, Noeva EA, Shchinova AM, Masenko VP, Arefieva TI, Merkulov EV, Samko AN, Provatorov SI, Kuznetsova TV. [The prognostic value of high-sensitivity C-reactive protein blood level after coronary stenting for the development of stent restenosis]. ACTA ACUST UNITED AC 2020; 60:64-71. [PMID: 33155942 DOI: 10.18087/cardio.2020.7.n1030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/29/2020] [Indexed: 11/18/2022]
Abstract
Aim To analyze the relationship between serum concentrations of high-sensitivity C-reactive protein (hsCRP) in dynamics and development of restenosis at 12 months following elective coronary stent placement (CSP).Material and methods The key role in atherogenesis, neointimal proliferation and restenosis belongs to inflammation. This study included 91 patients (median age, 60 [56; 66] years) with stable exertional angina after an elective CSP using second-generation stents. Follow-up coronarography was performed for 60 patients at 12 months. Concentration of hsCRP was measured immediately prior to CSP and at 1, 3, 6, and 12 months after CSP. Restenosis of the stented segment (50% or more narrowing of the stented segment or a 5-mm vessel segment proximally or distally adjacent to the stented segment) was observed in 8 patients.Results According to results of the ROC analysis, the increase in hsCRP concentration >0.9 mg/l (>25%) at one month after CSP had the highest predictive significance with respect of restenosis (area under the ROC curve, 0.89 at 95 % confidence interval (CI) from 0.79 to 0.99; sensitivity, 87.5 %; specificity, 82.8 %; р=0.0005), which was superior to the absolute value of hsCRP concentration >3.0 mg/l (area under the ROC curve, 0.82 at 95 % CI from 0.68 to 0.96; р=0.0007).Conclusion Increased concentration of hsCRP ≥0.9 mg /l (≥25 %) at a month after CSP was associated with restenosis of the coronary artery stented segment.
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Affiliation(s)
- A Yu Filatova
- National Medical Research Center of Cardiology of Russian Ministry of Health, Moscow
| | - G V Shlevkova
- National Medical Research Center of Cardiology of Russian Ministry of Health, Moscow
| | - A V Potekhina
- National Medical Research Center of Cardiology of Russian Ministry of Health, Moscow
| | - A K Osokina
- National Medical Research Center of Cardiology of Russian Ministry of Health, Moscow
| | - E A Noeva
- National Medical Research Center of Cardiology of Russian Ministry of Health, Moscow
| | - A M Shchinova
- National Medical Research Center of Cardiology of Russian Ministry of Health, Moscow
| | - V P Masenko
- National Medical Research Center of Cardiology of Russian Ministry of Health, Moscow
| | - T I Arefieva
- National Medical Research Center of Cardiology of Russian Ministry of Health, Moscow
| | - E V Merkulov
- National Medical Research Center of Cardiology of Russian Ministry of Health, Moscow
| | - A N Samko
- National Medical Research Center of Cardiology of Russian Ministry of Health, Moscow
| | - S I Provatorov
- National Medical Research Center of Cardiology of Russian Ministry of Health, Moscow
| | - T V Kuznetsova
- National Medical Research Center of Cardiology of Russian Ministry of Health, Moscow
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Abstract
BACKGROUND Coronary heart disease angina pectoris is a common clinical symptom in patients with coronary heart disease, due to coronary atherosclerotic stenosis or sputum leading to coronary insufficiency, myocardial transient ischemia, hypoxia caused by precordial pain as the main clinical manifestations Group syndrome. Coronary heart disease angina causes coronary blood flow insufficiency, cannot meet the normal activities of myocardial cells, leading to myocardial ischemia or necrosis. When the disease occurs, there is paroxysmal and crushing pain in the precordial area of the patient. Therefore, we recognize the importance of the disease and have paid enough attention. Clinical studies in recent years have found that the use of acupuncture in the treatment of angina pectoris has a good clinical application prospect. This study was conducted to study the effect of using acupuncture to treat angina pectoris. METHODS AND ANALYSIS We will search for PubMed, Cochrane Library, AMED, EMbase, WorldSciNet, Nature, Science online and China Journal Full-text Database, China Biomedical Literature CD-ROM Database (CBM), and related randomized controlled trials included in the China Resources Database. The time is limited from the construction of the library to November 2019. We will use the criteria provided by Cochrane 5.1.0 for quality assessment and risk assessment of the included studies, and use the Revman 5.3 and Stata13.0 software for meta-analysis of the effectiveness, recurrence rate, and symptom scores of angina pectoris. ETHICS AND DISSEMINATION This systematic review will evaluate the efficacy and safety of acupuncture for angina pectoris. Because all of the data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process Trial. REGISTRATION NUMBER PROSPERO CRD42019138003.
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Affiliation(s)
| | | | | | - Hong-wei Yuan
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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