RDW Value may Increase the Diagnostic Accuracy of MPS

Objectives: As the feasibility of obtaining health care has improved in the last decade, there is an increase in the number of performing unnecessary coronary angiogram. Red Cell Distribution Width (RDW), which shows erythrocyte dispersion volume, is associated with coronary artery disease. The present study aims to evaluate the relationship between RDW value and the severity of coronary artery disease in patients who undergo myocardial perfusion scintigraphy (MPS) as an evaluation for coronary ischemia and after which patients had a coronary angiography.
Methods: This retrospective study included 452 patients diagnosed as stabile angina that had MPS to evaluate coronary ischemia and after which coronary angiography was performed. Complete blood count was obtained on the same day. Patients were first divided into two groups: patients with and without ischemia on MPS. Then, the group who had ischemia on the MPS where divided into another two groups: patients who had RDW values ≥13.5 and the others who had RDW value <13.5. Patients who had fixed perfusion defect, chronic kidney disease, thyroid dysfunction, hematological disease, those who use iron supplements, and those who had active infectious disease were excluded from this study.
Results: The basic characteristics were the same between study groups. We found that severe coronary vessel disease, single vessel, two vessels and three vessels diseases were higher in patients who had ischemia on the MPS and RDW values ≥13.5 (p-value were 0.032, 0.004, 0.042 respectively). RDW values ≥13.5 was found to be an independent predictor for the presence of severe coronary artery disease (p<0.001 OR: 3.55).
Conclusion: Patients who have MPS for ischemic evaluation and RDW values of ≥ 13.5 were more severe coronary heart diseases. As a result, the findings suggest that using of RDW value is a cheap and feasible parameter that may prevent performing unnecessary coronary angiography for patients after MPS.

RDW Deðeri MPS’nin Diagnostik Doðruluðunu Artýrabilir mi?

Giriþ ve amaç; Saðlýk hizmetlerine eriþimin artmasý ile birlikte gereksiz koroner anjiyo sýklýðýnda artýþ olmuþtur. Red cell distribution width (RDW) eritrositlerin daðýlým hacmini gösterip koroner arter hastalýðý ile iliþki bulunmuþtur. Bu çalýþmadaki amaç miyokard perfüzyon sintigrafisi ile koroner iskemi araþtýrmasý yapýlýp koroner anjiyo planlanan hastalarda RDW deðerinin ciddi koroner lezyon saptanmasý arasýndaki iliþkiyi araþtýrmaktýr.
Materyal ve metod; Çalýþma retrospektif olarak yapýldý. Araþtýrmaya MPS ile koroner iskemi araþtýrmasý yapýldýktan sonra koroner anjiyo yapýlan 452 stabil anjina hastasý alýndý. Hastalara ayný gün hemogram bakýldý. Hastalar MPS’de iskemisi olan ve olmayan diye ve MPS’de iskemisi olanlar RDW düzeyi 13.5 ve üzeri ve 13.5 altý olmak üzere ikiþer gruba ayrýldý. MPS’de sabit perfüzyon defekti, kronik böbrek yetersizliði, tiroid disfonksiyonu, hematolojik hastalýk varlýðý, demir ilacý kullanýmý, aktif enfeksiyon çalýþma dýþý býrakýldý..
Bulgular; Her iki grupta temel karakteristik özellikler benzerdi. Ciddi damar hastalýðý, tek damar, iki damar ve üç damar MPS’de iskemisi olup RDW 13.5 ve üzerinde olan grupta daha yüksek saptandý. (p deðeri sýrasýyla <0.001, 0.036, 0.029, 0.005). Multivariant analizde ciddi koroner arter hastalýðýný göstermede RDW 13.5 ve üzeri olmasý baðýmsýz prediktör olarak saptandý (p<0.001 OR: 3.55).
Tartýþma ve sonuç; MPS ile iskemi araþtýrmasý yapýlýp RDW deðeri 13.5 üzerinde olan hastalarda daha fazla ciddi koroner arter hastalýðý saptanmýþtýr. MPS ile iskemi araþtýrmasý yapýlýp koroner anjiyo yapýlmasý planlanan hastalarda gereksiz anjiyolarýn önüne geçebilmek için ucuz ve kolay ulaþýlabilir bir parametre olan RDW göz önünde bulundurmalýdýr. (SETB-2018-12-165)