红细胞分布宽度预测急诊冠状动脉介入治疗的老年急性ST段抬高型心肌梗死病人预后的临床研究

doi:10.3969/j.issn.1003-9198.2025.11.012

Abstract

Abstract: Objective To investigate the predictive value of red blood cell distribution width(RDW)for the long-term prognosis of the elderly patients with acute ST-segment elevation myocardial infarction(STEMI). Methods The elderly patients with STEMI admitted to Nanjing First Hospital from July 2011 to April 2019 were continuously enrolled. Emergent percutaneous coronary intervention(PCI)was performed in all the patients. The general clinical data,laboratory results, coronary angiography and drug therapy data were collected. The primary endpoint was all-cause mortality. The secondary endpoint was myocardial infarction, cardiovascular death, ischemic stroke, stent thrombosis and target vessel revascularization. The primary safety endpoint was major bleeding(BRAC 3,5). Cox regression analysis was conducted to discover the influencing factors for the prognosis of the patients. Results A total of 625 patients with STEMI receiving PCI in the emergency department were enrolled with a median follow-up of 72(51-96) months. All-cause mortality occured in 97 patients. Receiver operating characteristic (ROC) curve analysis showed that at a cutoff value of 13.45 for RDW showed the highest predictive value for all-cause mortality in STEMI patients, with an area under the curve of 0.630, a sensitivity of 43.3%, and a specificity of 77.8%. Patients with high RDW tended to have a higher proportion of Killip Ⅲ-Ⅳ, higher levels of age, creatinine, urea nitrogen and hospital stays. Whereas,they had a lower proportion of diabetes and ticagrelor usage. Kaplan-Meier analysis demonstrated a significantly higher all-cause mortality in the high RDW group (log-rank P<0.001). Multivariate Cox regression analysis identified that age, creatine, RDW, left ventricular ejection fraction,single-vessel disease, beta-blockers and intra-aortic ballon pump(IABP) were independent predictive factors for all-cause mortality in the elderly patients with STMEI. Conclusions RDW is an affordable biomarker for predicting long term mortality in the elderly patients with STMEI.

Key words: aged, myocardial infarction, red blood cell distribution width, prognosis

CLC Number:

R 542.22

LU Hongjing, XU Haimei, ZHAO Yingying, JIN Guozhen, ZHEN Yaguo, LIN Song. Role of red blood cell distribution width in predicting long-term prognosis in elderly patients with acute ST-segment elevation myocardial infarction receiving percutaneous coronary intervention[J]. Practical Geriatrics, 2025, 39(11): 1130-1134.

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Role of red blood cell distribution width in predicting long-term prognosis in elderly patients with acute ST-segment elevation myocardial infarction receiving percutaneous coronary intervention

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