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Akut Koroner Sendromlu Hastalarda Eritrosit Dağılım Aralığının (RDW) Değerlendirilmesi

Year 2014, Volume: 15 Issue: 2, 99 - 105, 01.08.2014

Abstract

Objective: The RDW a recently described novel risk marker has been shown to be predictive of morbidity and mortality in variety of cardiovascular settings, and routinely reported as part of the complete blood count. We thought that RDW can increase in patient with ACS and investigated the effect of RDW on the clinical and angiographic classification of ACS. Material and Methods: 236 patients with ACS, 46 patients with heart failure and 136 control patients were included to the study. ACS group divided into four subgroups clinically (stabil AP, unstabil AP, acute MI, non-cardiac AP) and angiographically divided into three subgroups (critical vascular occlusion, non-critical vascular occlusion, normal). The groups were compared according to laboratory parameters. Results: There was difference between heart failure group and the other groups according to levels of total cholesterol, triglyceride, calcium and WBC. There was difference in all groups according to levels urea, creatinine, albumin, neutrophil count, RDW and troponin (p<0.05). In clinical classification, There was no difference in levels of RDW while there was a difference between acute MI group and the others in troponin level (p<0.05). In angiographic evaluation, there was difference between normal group and the others according to levels RDW (p<0.05). Conclusion: We detected that RDW were increased in patients presenting with ACS and heart failure, but we saw no difference between the subtypes of ACS. In conclusion, we think that RDW might be considered with other cardiac markers for the evaluation of ACS patients admitted to emergency departments

References

  • Evans TC, Jehle D. The red blood cell distribution width. J Emerg Med 1991;9(1):71-4.
  • Pierce CN, Larson DF. Inflammatory cytokine inhibition of erythropoiesis in patients implanted with a mechanical circulatory assist device. Perfusion 2005;20(2):83-90.
  • Kato H, Ishida J, Imagawa S, et al. Enhanced erythropoiesis mediated by activation of the renin- angiotensin system via angiotensin II type 1a receptor. FASEB J 2005;19(14):2023-5.
  • Biaggioni I, Robertson D, Krantz S, Jones M, Haile V. The anemia of primary autonomic failure and its reversal with recombinant erythropoietin. Ann Intern Med 1994;121(3):181-6.
  • Ndrepepa G, Kastrati A, Braun S, et al. N-terminal probrain natriuretic peptide and C-reactive protein in stable coronary heart disease. Am J Med 2006;119(4):355.e1
  • Dai DF, Hwang JJ, Lin JL, et al. Joint effects of N- terminal pro-B-type-natriuretic peptide and C- reactive protein vs angiographic severity in predicting major adverse cardiovascular events and clinical restenosis after coronary angioplasty in patients with stable 2008;72(8):1316-23. artery coronary disease. Circ J
  • Patel KV, Ferrucci L, Ershler WB, Longo DL, Guralnik JM. Red blood cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med 2009;169(5):515-23.
  • Perlstein TS, Weuve J, Pfeffer MA, Beckman JA. Red blood cell distribution width and mortality risk in a community-based prospective cohort. Arch Intern Med 2009;169(6):588-94.
  • Pascual-Figal DA, Bonaque JC, Redondo B, et al. Red blood cell distribution width predicts long-term outcome regardless of anaemia status in acute heart failure patients. Eur J Heart Fail 2009;11(9):840-6.
  • Förhécz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohászka Z, Jánoskuti L. Red cell distribution width in heart failure: prediction of clinical events and relationship erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J 2009;158(4):659-66.
  • Greer JP, Foerster J, Lukens JN, Rodgers GM, PAraksevas F, Glader BE (Editors). Wintrobe’s clinical hematology. In: Perkins SL. Examination pf blood and bone marrow. 11th Edition. Salt Lake City, Utah: Lippincott Wilkins & Williams; 2003:5-25.
  • Fukuta H, Ohte N, Mukai S, et al. Elevated plasma levels of B-type natriuretic peptide but not C-reactive protein are associated with higher red cell distribution width in patients with coronary artery disease. Int Heart J 2009;50(3):301-12.
  • Heymans S, Hirsch E, Anker SD, et al. Inflammation as a therapeutic target in heart failure? A scientific statement from the Translational Research Committee of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2009;11(2):119-29.
  • Ferrario M, Massa M, Rosti V, et al. Early haemoglobin-independent erythropoietin levels in patients with acute myocardial infarction. Eur Heart J 2007;28(15):1805- increase of plasma
  • Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med 2009;133(4):628-32.
  • Ferrucci L, Guralnik JM, Woodman RC, et al. Proinflammatory state and circulating erythropoietin in persons with and without anemia. Am J Med 2005;118(11):1288.
  • Uyarel H, Ergelen M, Cicek G, et al. Red cell distribution width as a novel prognostic marker in patients undergoing primary angioplasty for acute myocardial 2011;22(3):138-44. Coron Artery Dis
  • Azab B, Torbey E, Hatoum H, et al. Usefulness of red cell distribution width in predicting all-cause long- term mortality after non-ST-elevation myocardial infarction. Cardiology 2011;119(2):72-80.
  • Cavusoglu E, Chopra V, Gupta A, et al. Relation between red blood cell distribution width (RDW) and all-cause mortality at two years in an unselected population referred for coronary angiography. Int J Cardiol 2010;141(2):141-6.
  • Isik T, Uyarel H, Tanboga IH, et al. Relation of red cell distribution width with the presence, severity, and complexity of coronary artery disease. Coron Artery Dis 2012;23(1):51-6.
  • Warwick R, Mediratta N, Shaw M, et al. Red cell distribution width and coronary artery bypass surgery. Eur J Cardiothorac Surg 2013;43(6):1165-9.
  • Lippi G, Filippozzi L, Montagnana M, et al. Clinical usefulness of measuring red blood cell distribution width on admission in patients with acute coronary syndromes. Clin Chem Lab Med 2009;47(3):353-7.
  • Felker GM, Allen LA, Pocock SJ et al; CHARM Investigators. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol 2007;50(1):40.
  • Cotter G, Felker GM, Adams KF, Milo-Cotter O, O'Connor CM. The pathophysiology of acute heart failure--is it all about fluid accumulation? Am Heart J 2008;155(1):9-18.
  • Oh J, Kang SM, Hong N, et al. Relation between red cell distribution width with echocardiographic parameters in patients with acute heart failure. J Card Fail 2009;15(6):517-22.
  • Nishizaki Y, Yamagami S, Suzuki H, et al. Red blood cell distribution width as an effective tool for detecting fatal heart failure in super-elderly patients. Intern Med 2012;51(17):2271-6.

Akut Koroner Sendromlu Hastalarda Eritrosit Dağılım Aralığının (RDW) Değerlendirilmesi

Year 2014, Volume: 15 Issue: 2, 99 - 105, 01.08.2014

Abstract

Amaç: Günümüzde yeni bir risk belirteci olarak tanımlanmış olan eritrosit dağılım aralığı (RDW), birçok kardiyovasküler hastalıkta mortalite ve morbiditenin prediktif bir değeri olarak gösterilmektedir ve tam kan sayımında rutin olarak çalışılmaktadır. Biz, RDW’nin, akut koroner sendromlu (ACS) hastalarda yükselebileceğini düşündük ve çalışmamızda ACS’nin klinik ve anjiyografik sınıflaması üzerine etkisini araştırdık. Gereç ve Yöntem: Çalışmaya ACS’li 236 hasta, kalp yetmezlikli 46 hasta ve 136 kontrol grubu hastası dahil edildi. ACS grubundaki hastalar klinik olarak 4 alt gruba (stabil AP, unstabil AP, akut MI ve non-kardiyak AP) ve anjiyografik olarak 3 alt gruba (kritik damar darlığı, non-kritik damar ve normal) ayrıldı. Gruplar ve grupların alt tipleri çalışılan laboratuvar parametreleri açısından karşılaştırıldı. Bulgular: Kalp yetmezliği grubuyla diğer gruplar arasında total kolesterol, trigliserid, kalsiyum ve lökosit (WBC) seviyelerine göre anlamlı bir fark mevcuttu (p<0,05). Tüm gruplar arasında üre, kreatinin, albümin, nötrofil yüzdesi, RDW ve troponin seviyelerine göre anlamlı bir fark mevcuttu (p<0,05). Klinik sınıflamada, troponin seviyelerine göre akut MI grubu ile diğer gruplar arasında anlamlı bir fark mevcut iken (p<0,05), RDW seviyelerine göre anlamlı bir fark bulunamadı. Anjiyografik değerlendirmede RDW seviyelerine göre anjiyografisi normal olanlar ile diğer gruplar arasında belirgin bir fark mevcuttu (p<0,05). Sonuç: Biz akut koroner sendromlu ve kalp yetmezlikli hastalarda RDW seviyelerini yüksek tespit ettik, fakat ACS’ nin alt tipleri arasında anlamlı bir fark bulamadık. Sonuç olarak biz RDW’nin acil servise başvuran ACS’li hastaların değerlendirilmesi için diğer kardiyak belirteçlerle birlikte göz önünde bulundurulması gerektiğini düşünmekteyiz

References

  • Evans TC, Jehle D. The red blood cell distribution width. J Emerg Med 1991;9(1):71-4.
  • Pierce CN, Larson DF. Inflammatory cytokine inhibition of erythropoiesis in patients implanted with a mechanical circulatory assist device. Perfusion 2005;20(2):83-90.
  • Kato H, Ishida J, Imagawa S, et al. Enhanced erythropoiesis mediated by activation of the renin- angiotensin system via angiotensin II type 1a receptor. FASEB J 2005;19(14):2023-5.
  • Biaggioni I, Robertson D, Krantz S, Jones M, Haile V. The anemia of primary autonomic failure and its reversal with recombinant erythropoietin. Ann Intern Med 1994;121(3):181-6.
  • Ndrepepa G, Kastrati A, Braun S, et al. N-terminal probrain natriuretic peptide and C-reactive protein in stable coronary heart disease. Am J Med 2006;119(4):355.e1
  • Dai DF, Hwang JJ, Lin JL, et al. Joint effects of N- terminal pro-B-type-natriuretic peptide and C- reactive protein vs angiographic severity in predicting major adverse cardiovascular events and clinical restenosis after coronary angioplasty in patients with stable 2008;72(8):1316-23. artery coronary disease. Circ J
  • Patel KV, Ferrucci L, Ershler WB, Longo DL, Guralnik JM. Red blood cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med 2009;169(5):515-23.
  • Perlstein TS, Weuve J, Pfeffer MA, Beckman JA. Red blood cell distribution width and mortality risk in a community-based prospective cohort. Arch Intern Med 2009;169(6):588-94.
  • Pascual-Figal DA, Bonaque JC, Redondo B, et al. Red blood cell distribution width predicts long-term outcome regardless of anaemia status in acute heart failure patients. Eur J Heart Fail 2009;11(9):840-6.
  • Förhécz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohászka Z, Jánoskuti L. Red cell distribution width in heart failure: prediction of clinical events and relationship erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J 2009;158(4):659-66.
  • Greer JP, Foerster J, Lukens JN, Rodgers GM, PAraksevas F, Glader BE (Editors). Wintrobe’s clinical hematology. In: Perkins SL. Examination pf blood and bone marrow. 11th Edition. Salt Lake City, Utah: Lippincott Wilkins & Williams; 2003:5-25.
  • Fukuta H, Ohte N, Mukai S, et al. Elevated plasma levels of B-type natriuretic peptide but not C-reactive protein are associated with higher red cell distribution width in patients with coronary artery disease. Int Heart J 2009;50(3):301-12.
  • Heymans S, Hirsch E, Anker SD, et al. Inflammation as a therapeutic target in heart failure? A scientific statement from the Translational Research Committee of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2009;11(2):119-29.
  • Ferrario M, Massa M, Rosti V, et al. Early haemoglobin-independent erythropoietin levels in patients with acute myocardial infarction. Eur Heart J 2007;28(15):1805- increase of plasma
  • Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med 2009;133(4):628-32.
  • Ferrucci L, Guralnik JM, Woodman RC, et al. Proinflammatory state and circulating erythropoietin in persons with and without anemia. Am J Med 2005;118(11):1288.
  • Uyarel H, Ergelen M, Cicek G, et al. Red cell distribution width as a novel prognostic marker in patients undergoing primary angioplasty for acute myocardial 2011;22(3):138-44. Coron Artery Dis
  • Azab B, Torbey E, Hatoum H, et al. Usefulness of red cell distribution width in predicting all-cause long- term mortality after non-ST-elevation myocardial infarction. Cardiology 2011;119(2):72-80.
  • Cavusoglu E, Chopra V, Gupta A, et al. Relation between red blood cell distribution width (RDW) and all-cause mortality at two years in an unselected population referred for coronary angiography. Int J Cardiol 2010;141(2):141-6.
  • Isik T, Uyarel H, Tanboga IH, et al. Relation of red cell distribution width with the presence, severity, and complexity of coronary artery disease. Coron Artery Dis 2012;23(1):51-6.
  • Warwick R, Mediratta N, Shaw M, et al. Red cell distribution width and coronary artery bypass surgery. Eur J Cardiothorac Surg 2013;43(6):1165-9.
  • Lippi G, Filippozzi L, Montagnana M, et al. Clinical usefulness of measuring red blood cell distribution width on admission in patients with acute coronary syndromes. Clin Chem Lab Med 2009;47(3):353-7.
  • Felker GM, Allen LA, Pocock SJ et al; CHARM Investigators. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol 2007;50(1):40.
  • Cotter G, Felker GM, Adams KF, Milo-Cotter O, O'Connor CM. The pathophysiology of acute heart failure--is it all about fluid accumulation? Am Heart J 2008;155(1):9-18.
  • Oh J, Kang SM, Hong N, et al. Relation between red cell distribution width with echocardiographic parameters in patients with acute heart failure. J Card Fail 2009;15(6):517-22.
  • Nishizaki Y, Yamagami S, Suzuki H, et al. Red blood cell distribution width as an effective tool for detecting fatal heart failure in super-elderly patients. Intern Med 2012;51(17):2271-6.
There are 26 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Hüseyin Şahin This is me

Esra Poyraz This is me

Publication Date August 1, 2014
Published in Issue Year 2014 Volume: 15 Issue: 2

Cite

APA Şahin, H., & Poyraz, E. (2014). Akut Koroner Sendromlu Hastalarda Eritrosit Dağılım Aralığının (RDW) Değerlendirilmesi. Kocatepe Tıp Dergisi, 15(2), 99-105. https://doi.org/10.18229/ktd.74234
AMA Şahin H, Poyraz E. Akut Koroner Sendromlu Hastalarda Eritrosit Dağılım Aralığının (RDW) Değerlendirilmesi. KTD. August 2014;15(2):99-105. doi:10.18229/ktd.74234
Chicago Şahin, Hüseyin, and Esra Poyraz. “Akut Koroner Sendromlu Hastalarda Eritrosit Dağılım Aralığının (RDW) Değerlendirilmesi”. Kocatepe Tıp Dergisi 15, no. 2 (August 2014): 99-105. https://doi.org/10.18229/ktd.74234.
EndNote Şahin H, Poyraz E (August 1, 2014) Akut Koroner Sendromlu Hastalarda Eritrosit Dağılım Aralığının (RDW) Değerlendirilmesi. Kocatepe Tıp Dergisi 15 2 99–105.
IEEE H. Şahin and E. Poyraz, “Akut Koroner Sendromlu Hastalarda Eritrosit Dağılım Aralığının (RDW) Değerlendirilmesi”, KTD, vol. 15, no. 2, pp. 99–105, 2014, doi: 10.18229/ktd.74234.
ISNAD Şahin, Hüseyin - Poyraz, Esra. “Akut Koroner Sendromlu Hastalarda Eritrosit Dağılım Aralığının (RDW) Değerlendirilmesi”. Kocatepe Tıp Dergisi 15/2 (August 2014), 99-105. https://doi.org/10.18229/ktd.74234.
JAMA Şahin H, Poyraz E. Akut Koroner Sendromlu Hastalarda Eritrosit Dağılım Aralığının (RDW) Değerlendirilmesi. KTD. 2014;15:99–105.
MLA Şahin, Hüseyin and Esra Poyraz. “Akut Koroner Sendromlu Hastalarda Eritrosit Dağılım Aralığının (RDW) Değerlendirilmesi”. Kocatepe Tıp Dergisi, vol. 15, no. 2, 2014, pp. 99-105, doi:10.18229/ktd.74234.
Vancouver Şahin H, Poyraz E. Akut Koroner Sendromlu Hastalarda Eritrosit Dağılım Aralığının (RDW) Değerlendirilmesi. KTD. 2014;15(2):99-105.

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