The impact of admission red cell distribution width on long-term cardiovascular events after primary percutaneous intervention: A four-year prospective study

Background: Red cell distribution width (RDW) is an indicator of erythrocyte in different size, and its prognostic value has been demonstrated in numerous cardiac and non-cardiac diseases. The purpose of this study was to evaluate the predictive value of RDW on the long- -term cardiovascular events in patients undergoing primary percutaneous coronary intervention (PCI). Methods: Ninety-six consecutive patients (mean age 60.6 ± 12.5 years, 77.1% male) with ST-segment elevation myocardial infarction (STEMI), who were treated with primary PCI, were analyzed prospectively. Baseline RDW and high sensitive C-reactive protein (hs-CRP) were measured. The patients were followed up for major adverse cardiac events (MACE) for up to 48 months after discharge. Results: There were 30 patients with long-term MACE (Group 1) and 66 patients without long-term MACE (Group 2). Age, admission RDW, hs-CRP and creatine kinase-MB levels, heart rate after PCI, previously used angiotensin converting enzyme inhibitor, left anterior descending artery lesion, and electrocardiographic no-reflow were higher in Group 1. Admission hemoglobin levels were lower in Group 1. An RDW level ≥ 13.85% measured on admission had 80% sensitivity and 64% specificity in predicting long-term MACE on receiver-operating characteristic curve analysis. In multivariate analyses, only admission RDW (HR 5.26, < 95% CI 1.71–16.10; p = 0.004) was an independent predictor of long-term MACE. Conclusions: A high baseline RDW value in patients with STEMI undergoing primary PCI is independently associated with increased risk for long term MACE

Arrhythmogenic Potential of Vitamin D Insufficiency

WOS: 000375337700022Introduction: Although the reports are also present demonstrating the exact opposite, general opinion is that vitamin D has favorable effects on cardiovascular system. The association between vitamin D insufficiency and coronary artery disease, heart failure and hypertension were well demonstrated. Nevertheless the impact of vitamin D insufficiency on arrhythmia remains unclear. Materials and methods: Low vitamin D and control groups consisted of 74 and 80 patients respectively. Parameters of arrhythmia including QT and P wave dispersion, SDNN, SDNN-index, pNN50, RMSSD, HF and LF as well as the number of atrial pre-systole, atrial pair; supraventricular tachycardia, ventricular pre-systole, ventricular pair, non-sustained ventricular tachycardia, sustained ventricular tachycardia were compared between the patients with vitamin D insufficiency and controls. Results: Maximum QTc, minimumQTc, QTc dispersion, maximum p wave, minimum p wave, p wave dispersion, SDNN, SDNN index, RMSSD, pNN50, HF and LF values were found to be similar between low vitamin D and control groups (p>0,05). Furthermore there was not a significant difference in the number of atrial pre-systole, atrial pair, supraventricular tachycardia, ventricular pre-systole, ventricular pail; non-sustained ventricular tachycardia and sustained ventricular tachycardia (p>0,05). Additionally, serum vitamin D levels were not found to be correlated with QTc dispersion and SDNN (r=-0,010, p=0,933 and r=-0,034, p=0,777 respectively). Conclusion: Serum vitamin D levels do not have any impact on the current arrhythmic status and the risk of developing arrhythmia. Beside the questioned value of vitamin D in general cardiovascular outcomes, arrhythmia is unlikely to be a component of the possible effects of vitamin D insufficiency on cardiovascular system