Association of Red Cell Distribution with Angiographic Severity of Coronary Artery Disease Assessed by SYNTAX Score in Non-ST Elevation Myocardial Infarction

Background: Red cell distribution width is a simple measure of red cell size heterogeneity (i.e.,
anisocytosis) in peripheral blood measured by hematology auto analyzer and has been shown to be
a predictor of poor outcomes in various cardiovascular conditions including coronary artery disease
(CAD). The present study was intended to find the association between RDW-CV and severity of
CAD in NSTEMI patients.
Methods: The present cross-sectional analytical study was carried out in the Department of
Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh, from
June 2018 to July 2019. A total of 70 NSTEMI patients undergoing coronary angiogram during the
index hospitalization were included in the study. They were divided into two groups on the basis of
RDW-CV (Group-I RDW-CV <14.3%; Group-II RDW-CV ≥14.3%). Severity of coronary artery disease
was determined by SYNTAX score and correlation between RDW-CV and SYNTAX score was
assessed.
Results: SYNTAX score was significantly higher in patients with RDW-CV ≥14.3% than that in
patients with RDW-CV <14.3% (24.51±9.76 vs. 13.5±7.71, p<0.0001). The risk of having severe CAD
in patients with RDW-CV ≥14.3%was 3.844(95% CI = 1.429-10.340) (p <0.008) times higher in terms
of SYNTAX score. A significant positive correlation between RDW-CV and SYNTAX score was
noted (r = 0.681, p value < 0.0001).
Conclusion: It may be concluded that RDW-CV was significantly associated with the severity of
coronary artery disease in NSTEMI patients and it may be considered as an independent predictor
of severity of CAD. It is easy to assess and inexpensive. So, before performing coronary angiography,
it appears to be additive to conventional risk factors and commonly used biomarkers for risk
stratification.