Relationship Between Red Blood Cell Distribution Width and No-Reflow In ST-Elevation Myocardial Infarction patients Undergoing Primary Percutaneous Coronary Intervention

Authors

  • Zeeshan Ishaq Department of Adult Cardiology, Armed Forces Institute of Cardiology/ National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Iftikhar Ahmed Department of Adult Cardiology, Armed Forces Institute of Cardiology/ National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Asif Nadeem Department of Adult Cardiology, Armed Forces Institute of Cardiology/ National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Nadia Aman Department of Adult Cardiology, Armed Forces Institute of Cardiology/ National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Muhammad Masoom Department of Adult Cardiology, Armed Forces Institute of Cardiology/ National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Javeria Kamran Department of R& D, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Muhammad Saad Mukhtar Department of Adult Cardiology, Armed Forces Institute of Cardiology/ National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Tasleem Akhtar Department of Adult Cardiology, Armed Forces Institute of Cardiology/ National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Rawalpindi, Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74iSUPPL-1.11762

Keywords:

No-reflow Phenomenon, Red cell distribution width, ST-Segment Elevation Myocardial Infarction

Abstract

Objective: To find the association between Red Blood Cell Distribution Width (RDW) and the incidence of no-reflow in ST-Elevation Myocardial Infarction patients treated with Primary Percutaneous Coronary Intervention.

Study Design: Analytical Cross-sectional study.

Place and Duration of Study: At Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi Pakistan, from Aug 2023 to Feb 2024.

Methodology: Total one hundred and thirty-nine patients who underwent Primary Percutaneous Coronary Intervention within 24 hours of symptoms onset were enrolled via consecutive sampling for study purpose. RDW values were noted from Complete Blood Count conducted upon the patients' arrival at the emergency department. Thrombolysis in Myocardial Infarction grading system was utilized to assess the scale of blood flow during angiography. On the basis of mean RDW value, participants were categorized into two groups: Group-I=RDW<14 and Group-II=RDW≥14. Receiver Operating Characteristics curve was generated to evaluate the predictive capability of RDW values for identifying cases of no-reflow. The association of study variables with RDW was assessed by applying Chi-square test, and significance level was set at p<0.05.

Results: Out of 139 participants, 118(84.9%) were males and 21(15.1%) were females. The mean age of study sample was 61.75±10.91 years. 64(46.0%) patients were present in RDW<14 group and 75(53.9%) in RDW≥14 group. Out of 64, the incidence of No Reflow Phenomenon (NRP)/slow flow was 28(43.8%) in Group-I while in Group-II, it was ............

Conclusion: RDW does not independently predict no-reflow.............

Downloads

Download data is not yet available.

References

Ahmad S, Sohail A, Chishti MAS, Azeem T. Prevalence of ST-Segment Elevation Myocardial Infarction (STEMI) in Pakistan and the Role of Primary Percutaneous Coronary Intervention (PPCI). Annals of King Edward Medical University. 2022; 28(2): 259-67. https://doi.org/10.21649/akemu.v28i2.5119

Singh AK, Jat RK. Myocardial Infarction. Himalayan Journal of Health Sciences. 2021:16-32.

https://doi.org/10.22270/hjhs.v6i4.116

Mitsis A, Gragnano F. Myocardial Infarction with and without ST-segment Elevation: a Contemporary Reappraisal of Similarities and Differences. Current cardiology reviews. 2021; 17(4). https://doi:10.2174/1573403X16999201210195702

Vidal-Calés P, Cepas-Guillén PL, Brugaletta S, Sabaté M. New interventional therapies beyond stenting to treat ST-segment elevation acute myocardial infarction. Journal of Cardiovascular Development and Disease. 2021; 8(9): 100.

https://doi.org/10.3390/jcdd8090100

Buono A, Gori T. No-reflow phenomenon in acute myocardial infarction: Relieve pressure from the procedure and focus attention to the patient. International Journal of Cardiology Heart & Vasculature. 2019; 24. https://doi:10.1016/j.ijcha.2019.100417

Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation. 2008; 117(2): 163-8.

https://doi: 10.1161/CIRCULATIONAHA.107.727545

Celık T, Balta S, Demır M, Yıldırım AO, Kaya MG, Ozturk C, et al. Predictive value of admission red cell distribution width-platelet ratio for no-reflow phenomenon in acute ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Cardiology journal. 2016; 23(1): 84-92. https://doi: 10.5603/CJ.a2015.0070

Sun Y, Ren J, Li L, Wang C, Yao H. RDW as A Predictor for No-Reflow Phenomenon in DM Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Journal of Clinical Medicine. 2023; 12(3): 807. https:// doi:10.3390/jcm12030807

Allencherril J, Jneid H, Atar D, Alam M, Levine G, Kloner RA, et al. Pathophysiology, diagnosis, and management of the no-reflow phenomenon. Cardiovascular Drugs and Therapy. 2019; 33: 589-97. https://doi:10.1007/s10557-019-06901-0

Feher A, Chen SY, Bagi Z, Arora V. Prevention and treatment of no-reflow phenomenon by targeting the coronary microcirculation. Reviews in cardiovascular medicine.2014; 15(1): 38-51. https://doi: 10.3909/ricm0699

Caiazzo G, Musci RL, Frediani L, Umińska J, Wanha W, Filipiak KJ, et al. State of the art: no-reflow phenomenon. Cardiology Clinics. 2020; 38(4): 563-73. https://doi:10.1016/j.ccl.2020.07.001

Hoffmann JJ, Urrechaga E. Role of RDW in mathematical formulas aiding the differential diagnosis of microcytic anemia. Scandinavian journal of clinical and laboratory investigation. 2020; 80(6): 464-9.

https://doi.org/10.1080/00365513.2020.1774800

Uyarel H, Ergelen M, Cicek G, Kaya MG, Ayhan E, Turkkan C, et al. Red cell distribution width as a novel prognostic marker in patients undergoing primary angioplasty for acute myocardial infarction. Coronary artery disease. 2011; 22(3): 138-44.

https:// doi: 10.1097/MCA.0b013e328342c77b

Xanthopoulos A, Giamouzis G, Dimos A, Skoularigki E, Starling RC, Skoularigis J, et al. Red blood cell distribution width in heart failure: pathophysiology, prognostic role, controversies and dilemmas. Journal of Clinical Medicine. 2022; 11(7): 1951. https:// doi: 10.3390/jcm11071951

Dvornik Š, Zaninović Jurjević T, Jurjević N, Lekić A, Zaputović L. Prognostic factors for in-hospital mortality of patients hospitalized for acutely decompensated heart failure. Acta clinica belgica. 2018; 73(3): 199-206.

https:// doi: 10.1080/17843286.2017.1410599

Saberi A, Gazanchian M, Sadeghi R, Eshraghi A. Platelet-To-Lymphocyte Ratio as a Predictor of No-Reflow after Primary Percutaneous Coronary Intervention in Patients with ST Elevation Myocardial Infarction: A Systematic Review and Meta-Analysis. Journal of Cardio-Thoracic Medicine. 2019; 7(2). https://doi:10.22038/JCTM.2019.39393.1219

Arafa O, Tabl M, Elnagar A, Saleh M. Red cell distribution width to platelet ratio as a predictor of no-reflow phenomenon in patients with ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Benha Journal of Applied Sciences. 2021; 6(4): 305-10.

https:// doi:10.21608/BJAS.2021.197998

Celik T, Balta S, Ozturk C, Kaya MG, Aparci M, Yildirim OA, et al. Predictors of no-reflow phenomenon in young patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Angiology. 2016; 67(7): 683-9.https://doi: 10.1177/0003319715605977

Kaur G, Baghdasaryan P, Natarajan B, Sethi P, Mukherjee A, Varadarajan P, et al. Pathophysiology, diagnosis, and management of coronary no-reflow phenomenon. International Journal of Angiology. 2021; 30(01): 015-21.

https://doi:10.1055/s-0041-1725979

Cardounel AJ, Cui H, Samouilov A, Johnson W, Kearns P, Tsai A-L, et al. Evidence for the pathophysiological role of endogenous methylarginines in regulation of endothelial NO production and vascular function. Journal of Biological Chemistry. 2007; 282(2): 879-87.

https://doi: 10.1074/jbc.M603606200

Hu Y, Liu H, Fu S, Wan J, Li X. Red blood cell distribution width is an independent predictor of AKI and mortality in patients in the coronary care unit. Kidney and Blood Pressure Research. 2018; 42(6): 1193-204. https://doi: 10.1159/000485866

Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: a simple parameter with multiple clinical applications. Critical reviews in clinical laboratory sciences. 2015; 52(2): 86-105.

https://doi.org/10.3109/10408363.2014.992064

Downloads

Published

30-05-2024

Issue

Section

Original Articles

How to Cite

1.
Ishaq Z, Ahmed I, Nadeem A, Aman N, Masoom M, Kamran J, et al. Relationship Between Red Blood Cell Distribution Width and No-Reflow In ST-Elevation Myocardial Infarction patients Undergoing Primary Percutaneous Coronary Intervention. Pak Armed Forces Med J [Internet]. 2024 May 30 [cited 2024 Jul. 27];74(SUPPL-1):S22-S26. Available from: https://pafmj.org/PAFMJ/article/view/11762