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

P. Buller, Adam Kern, Maciej Tyczyński, Wojciech Rosiak, Wojciech Figatowski, R. Gil, J. Bil
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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.
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5年随访中全血细胞计数衍生指标对MINOCA患者主要心血管不良事件的预测价值
作者分析了红细胞和血小板指标,如红细胞分布宽度(RDW)、平均红细胞体积(MCV)和平均血小板体积(MPV)作为非阻塞性冠状动脉(MINOCA)心肌梗死患者5年预后预测因素的潜力。材料和方法:2010-2015年间,确定了112例最终MINOCA诊断和现有实验室结果的患者。主要终点是5年主要不良心血管事件发生率,定义为心源性死亡、心肌梗死或因心绞痛住院。结果:只有RDW对长期预后有显著影响。RDW≤14.5的患者93例(83%)(第1组),RDW > 14.5的患者19例(17%)(第2组),RDW平均值为13.58±1.11%。1组和2组的RDW平均值分别为13.18±0.55%和15.54±1.06% (p < 0.001)。RDW值异常的患者(2组)左心室射血分数较低(60±8% vs. 53±13%,p = 0.024), NT-proBNP值较高(3170±5285 pg/mL vs. 6200±4,223 pg/mL, p = 0.013),肌钙蛋白水平较高(501 ~ 2500 ng/mL: 31% vs. 53%, p = 0.02)。仅在全因死亡中观察到统计学上的显著差异。无RDW≤14.5%组和RDW > 14.5%组的全因死亡率分别为2.2%和21.1% (HR 5.09, 95% CI 1.03-25.2, p = 0.046)。结论:RDW与5年MINOCA患者全因死亡风险增加显著相关。
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