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• W2020075067 abstract "Lee JH et al. Clin Cardiol. 2013;36:336–341. We read with interest the article the titled “Incremental Predictive Value of Red Cell Distribution Width for 12-Month Clinical Outcome After Acute Myocardial Infarction” by Lee et al.1 The authors aimed to investigate the incremental value of red cell distribution width (RDW) to the established risk factors in predicting clinical outcomes after acute myocardial ınfarction (AMI). They reported that baseline RDW level at admission was an independent prognostic factor for 12-month major adverse cardiac events in patients with AMI. The ready availability of RDW measurements at no additional cost may encourage its wider use in clinical practice. Inflammation is a significant feature of arteriosclerotic disease, and the vulnerability of coronary plaques in AMI may be related to the levels of serum inflammatory indicators.2 Some markers have been found to be associated with early and late complications in patients with AMI. Preprocedural serum inflammatory markers such as C-reactive protein (CRP) level may be associated with early complications3 and long-term prognosis4 in patients undergoing percutaneous coronary intervention.5 Inflammatory markers are considered a major risk factor predisposing to cardiovascular morbidity and mortality.6 Recently, a number of studies have reported that elevated RDW levels are associated with poor prognosis in the setting of stable angina, acute coronary syndrome, coronary bypass surgery, heart failure, stroke, peripheral arterial disease, older age, and in patients with or without coronary artery disease (CAD).7 RDW is a measure of the variability in the size of circulating red blood cells and is a part of the complete blood count panel. A significant association between anemia with adverse outcomes (death, stroke, and renal impairment) in patients with CAD has been demonstrated in previous studies.8 Nowadays, although anemia is a predictor of postoperative complications and is a risk factor for mortality in patients after cardiac surgery, RDW is known as an independent early marker of new-onset anemia, providing predictive information for hematologic abnormalities beyond hemoglobin concentrations and other known risk factors. It is commonly used as a method for the differential diagnosis of anemia and could be elevated in any conditions where reticulocytes are released into circulation. RDW is also independently associated with mortality in both the general population and in patients with certain diseases. RDW has recently been defined to highly correlate with short- and long-term outcomes in different clinical settings. However, RDW may also reflect ethnicity, neurohumoral activation, renal dysfunction, thyroid disease, hepatic dysfunction, nutritional deficiencies (ie, iron, vitamin B12, and folic acid), bone marrow dysfunction, inflammatory diseases, chronic or acute systemic inflammation,9 and use of some medications or could represent an integrative measure of all these pathological processes occurring during the progression of CAD. Finally, not only RDW but also mean platelet volume,10 neutrophil lymphocyte ratio,11 CRP, and uric acid are easy methods to evaluate the cardiovascular disease of patients.12 These markers might be useful in clinical practice.13 Finally, because the authors evaluated patients with AMI retrospectively in their study,1 the authors might not have accurately defined how much time elapsed before measuring RDW levels; delaying blood sampling may lead to abnormal results in RDW measurements.14 In conclusion, we believe that the findings of the current study will lead to further studies examining the relationship between RDW and AMI. However, RDW alone without other inflammatory indicators may not provide enough information about the inflammatory status and prognosis. We suggest that RDW be evaluated together with other serum inflammatory markers. Sait Demirkol, MD Sevket Balta, MD Ugur Kucuk, MD Department of Cardiology Omer Kurt, MD Hakan Sarlak, MD Department of Internal Medicine Gulhane Medical Academy Ankara, Turkey Hilal Olgun Kucuk, MD Department of Cardiology Van Education and Research Hospital, Van, Turkey" @default.
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• W2020075067 date "2013-07-01" @default.
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• W2020075067 title "Response to Incremental Predictive Value of Red Cell Distribution Width for 12-Month Clinical Outcome After Acute Myocardial Infarction" @default.
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• W2020075067 doi "https://doi.org/10.1002/clc.22191" @default.
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