Red cell distribution width predicts contrast-induced nephropathy in patients undergoing percutaneous coronary intervention for acute coronary syndrome

Angiology. 2015 May;66(5):433-40. doi: 10.1177/0003319714535238. Epub 2014 May 16.

Abstract

We investigated the relationship between red cell distribution width (RDW) and contrast-induced nephropathy (CIN) in patients (aged 61 ± 12, 69% men) with acute coronary syndrome (ACS). Consecutive patients diagnosed with ACS (n = 662) who underwent percutaneous coronary intervention (PCI) were included in the study. Patients were divided into 2 groups: CIN and no CIN. Contrast-induced nephropathy was defined as an increase in serum creatinine level of ≥0.5 mg/dL or ≥25% above baseline within 72 hours after PCI. Contrast-induced nephropathy occurred in 81 (12.2%) patients. Red cell distribution width, creatinine, and high-sensitivity C-reactive protein levels were significantly higher in the CIN group than in the no-CIN group. Multivariate regression analysis revealed that baseline RDW level (odds ratio 1.379, 95% confidence interval 1.084-1.753, P = .009), age (P = .025), creatinine (P = .004), and left ventricular ejection fraction (P = .011) were independent risk factors for the development of CIN. In conclusion, increased RDW levels are independently associated with a greater risk of CIN in patients undergoing PCI for ACS.

Keywords: acute coronary syndrome; contrast-induced nephropathy; percutaneous coronary intervention; red cell distribution width.

MeSH terms

  • Acute Coronary Syndrome / blood
  • Acute Coronary Syndrome / diagnostic imaging
  • Acute Coronary Syndrome / physiopathology
  • Acute Coronary Syndrome / therapy*
  • Aged
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Chi-Square Distribution
  • Contrast Media / adverse effects*
  • Coronary Angiography / adverse effects*
  • Creatinine / blood
  • Erythrocyte Indices*
  • Female
  • Humans
  • Inflammation Mediators / blood
  • Kidney Diseases / blood
  • Kidney Diseases / chemically induced*
  • Kidney Diseases / diagnosis
  • Kidney Diseases / physiopathology
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Percutaneous Coronary Intervention / adverse effects*
  • Predictive Value of Tests
  • Radiography, Interventional / adverse effects*
  • Risk Factors
  • Stroke Volume
  • Treatment Outcome
  • Up-Regulation
  • Ventricular Function, Left

Substances

  • Biomarkers
  • Contrast Media
  • Inflammation Mediators
  • C-Reactive Protein
  • Creatinine