The Relationship between Red Cell Distribution Width and Residual SYNTAX Scores in ST-Segment Elevation Myocardial Infarction Patients after Percutaneous Coronary Intervention

Abstract

Objective. Residual SYNTAX score (rSS) values have been suggested to serve as an independent predictor of mortality in ST-segment elevation myocardial infarction (STEMI) patients following percutaneous coronary intervention (PCI). Prior work has also indicated that red cell distribution width (RDW) can predict the incidence of major adverse cardiac events (MACEs) in STEMI patients. As such, we sought to explore the relationship between RDW and rSS in STEMI patients that have undergone PCI. Methods. In total, 456 eligible patients were recruited for this study. Youden’s index was used to calculate the optimal RDW cut-off value, after which the relationship between RDW and rSS values was assessed through Spearman’s correlation analyses. Independent predictors of high rSS levels were then identified via multivariate logistic regression analysis. Results. Patients were separated into two groups based upon whether they exhibited high RDW levels (>13.9, Group 1) or low RDW levels (<13.9, Group 2). The average rSS value of patients in Group 2 was found to be significantly decreased compared to patients in Group 1 ( $P<0.001$ ). RDW values were found to be positively correlated with rSS ( $r=0.604$ , $P<0.001$ ), and multivariate logistic regression analysis determined that high RDW levels were independently predictive of higher rSS ( $\text{OR}=27.1$ [14.8-51.7]; $P<0.001$ ). Additionally, a nomogram incorporating RDW exhibited good calibration, discriminative capacity, and clinical utility. Conclusions. In summary, RDW is strongly correlated with rSS in STEMI patients following PCI, with high RDW levels serving as an independent predictor of high rSS in this patient population.