Additional value of the red blood cell distribution width to the Mehran risk score for predicting contrast-induced acute kidney injury in patients with ST-elevation acute myocardial infarction.
J Cardiol. 2015 Jul;66(1):41-5
Authors: Mizuno A, Ohde S, Nishizaki Y, Komatsu Y, Niwa K
BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention in patients with ST-elevation myocardial infarction (STEMI) is a common complication associated with worse outcome. Considering the prognostic predictive value of the red cell distribution width (RDW), we aimed to measure the usefulness of RDW for predicting CI-AKI.
METHODS: All consecutive STEMI patients without hemodialysis from June 2011 to September 2013 admitted to St. Luke's International Hospital were enrolled. We performed primary percutaneous coronary intervention in all patients. CI-AKI was defined as a >25% increase or an absolute increase in serum creatinine of 0.5mg/dl within 3 days after percutaneous coronary intervention. The potential additional predictive value of RDW with the Mehran risk score (MRS) on admission was estimated.
RESULTS: A total of 102 patients (78.4% males) were analyzed - 10 of the 102 (10%) STEMI patients developed CI-AKI. Multivariate analysis showed that RDW was an independent variable predicting CI-AKI in these patients [odds ratio, 2.029; 95% confidence interval (95% CI), 1.029-3.999; p=0.041]. The areas under the receiver operating characteristic curves for MRS only, RDW only, and the combined model (MRS and RDW) for the prediction of CI-AKI were 0.806 (95% CI, 0.696-0.917), 0.719 (95% CI, 0.536-0.902), and 0.846 (95% CI, 0.744-0.949), respectively.
CONCLUSION: We showed the potential predictive ability of RDW, only if used with MRS, for CI-AKI in STEMI patients. Further evaluation of RDW for predicting CI-AKI in patients with STEMI is needed.
PMID: 25448729 [PubMed - indexed for MEDLINE]