Red Cell Distribution Width as a Marker for Predicting In-Stent Rest Enosis after Percutaneous Coronary Intervention

Objective: Red Cell Distribution Width (RDW) has recently been considered as a predictor of a variety of cardiovascular diseases. However, no data is currently available with respect to the role of RDW in predicting In-Stent Rest enosis (ISR) after successful coronary stent implantation. Methods: A cohort of 1733 consecutive patients was retrospectively enrolled who had a received coronary angiography follow-up at mean 7 months after stinting. Of them, 271 lesions were implanted with a Bare-Metal Stent (BMS) while 404 lesions with a Drug-Eluting Stent (DES). The relationship of admission RDW value and angiography-proven ISR at 7 months were evaluated. Results: There were 106 patients with ISR (106/675, 15.7%; BMS, n=271, ISR=82, 30.3%; DES, n=404, ISR=24, 5.9%) and 569 patients without ISR at 7-month angiographic follow-up. Baseline RDW values were significantly higher in patients with ISR (RDW: 13.9±2.2 versus 12.5±2.0, p<0.001). In addition, the elevated RDW levels were found to be associated with ISR regardless of BMS or DES implantation. Moreover, there was a positive correlation between levels of RDW and CRP in patients with ISR (&ga= 0.661, p=0.000). Finally, in a Receiver Operating Characteristic (ROC) curve analysis, an RDW = 13.4% on admission had 71% sensitivity and 68% specificity in predicting the ISR after successful PCI. Conclusion: The present study provides the first line of evidence for the use of RDW, an easy, inexpensive, routinely reported marker, as an independent predictor for ISR after successful coronary stent implantation.