Red Blood Cell Distribution Width as a 5-Year Prognostic Marker in Patients Submitted to Carotid Endarterectomy

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Duarte-Gamas, L (Author) Other; Pereira-Neves, A (Author) FMUP; Jácome, F (Author) Other; Fragão-Marques, M (Author) FMUP; Vaz, R (Author) FMUP; Andrade, JP (Author) FMUP; Rocha-Neves, J (Author) FMUP

Journal

Title: Cerebrovascular Diseases Extra

Vol. 10

Pages: 181-192

Publisher: Karger

Indexing

ISI Web of Knowledge - 10 Citations

Scopus - 10 Citations

Other information

Authenticus ID: P-00T-8TZ

DOI: 10.1159/000512587

Abstract (EN): <jats:p><b><i>Objective:</i></b> Patients submitted to carotid artery endarterectomy (CEA) have a long-term risk of major adverse cardiovascular events (MACE) of 6¿9% at 2 years. Hematological parameters have been shown to have a predictive function in atherosclerotic diseases, namely the red blood cell distribution width-coefficient of variation (RDW-CV). This parameter has been associated with worse outcomes such as myocardial infarction (MI), stroke, and all-cause mortality. This study aims to evaluate the potential role of preoperative hematologic parameters such as RDW-CV in predicting perioperative and long-term cardiovascular adverse events and mortality in patients submitted to CEA. <b><i>Methods:</i></b> From January 2012 to January 2019, 180 patients who underwent CEA with regional anesthesia in a tertiary care and referral center were selected from a prospective cohort database. Blood samples were collected preoperatively 2 weeks before admission, including a full blood count. The primary outcome included long-term MACE. Secondary outcomes included all-cause mortality, stroke, MI, acute heart failure, and major adverse limb events (MALE). <b><i>Results:</i></b> At baseline, 27.2% of patients had increased RDW-CV. Increased RDW-CV was independently associated with baseline hemoglobin (adjusted odds ratio [aOR] 0.715, 95% CI 0.588¿0.869, <i>p</i> = 0.001) and atrial fibrillation (aOR 4.028, 95% CI 1.037¿15.639, <i>p</i> = 0.001). After a median follow-up of 50 months, log-rank univariate analysis of RDW-CV demonstrated a significant association between increased RDW-CV and long-term all-cause mortality (log-rank <0.001), MACE (log-rank <0.001), and MI (log-rank = 0.017). After multivariate Cox regression analysis, increased RDW-CV was associated with increased long-term mortality (adjusted hazard ratio [aHR] 2.455, 95% CI 1.231¿4.894, <i>p</i> = 0.011) and MACE (aHR 2.047, 95% CI 1.202¿3.487, <i>p</i> = 0.008). A decreased hemoglobin to platelet ratio (aHR 2.650e¿8, 95% CI 9.049e¿15 to 0.078, <i>p</i> = 0.019) was also associated with all-cause mortality. <b><i>Conclusion:</i></b> RDW is a widely available and low-cost marker that independently predicts long-term mortality, MACE, and MI after CEA. This biomarker could prove useful in assessing which patients would likely benefit from CEA in the long term. </jats:p>

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 12