Coşkun A, Eren SH. R/S ratio in lead II, and the prognostic significance of red cell distribution width in acute coronary syndrome. World J Clin Cases 2019; 7(16): 2217-2226 [PMID: 31531316 DOI: 10.12998/wjcc.v7.i16.2217]
Corresponding Author of This Article
Abuzer Coşkun, MD, Associate Specialist, Doctor, Department of Emergency, Sivas Numune Hospital, Yesilyurt Mah. Sifa Street, Sivas 58000, Turkey. dr.acoskun44@hotmail.com
Research Domain of This Article
Emergency Medicine
Article-Type of This Article
Clinical Trials Study
Open-Access Policy of This Article
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World J Clin Cases. Aug 26, 2019; 7(16): 2217-2226 Published online Aug 26, 2019. doi: 10.12998/wjcc.v7.i16.2217
Table 1 Baseline characteristics of acute coronary syndrome study patients
All patients
Patients with
z
P-value
RSR > 1
RSR < 1
Baseline characteristics
Age, mean ± SD, yr
61.56 ± 9.42
60.9 ± 11.36
62.22 ± 10.40
-0.706
0.001
Sex, Male/Female
830/466
255/109
575/357
0.002
Laboratory finding
TG, mg/dL
141.69 ± 81.30
139.30 ± 75.97
143.71 ± 85.52
-0.195
0.232
CHOL, mg/dL
173.71 ± 72.40
173.00 ± 70.72
174.30 ± 74.18
-0.156
0.286
HDL, mg/dL
34.44 ± 9.13
34.14 ± 9.23
34.44 ± 9.14
-0.057
0.398
LDL, mg/dL
108.75 ± 50.88
108.97 ± 50.91
108.56 ± 50.87
-0.404
0.065
LVEF, %
52.29 ± 14.27
41.17 ± 10.41
54.30 ± 11.48
-6.704
0.001
GS
37.88 ± 36.7
48.39 ± 36.44
29.74 ± 37.56
-7.549
0.001
cTn 1, ng/mL
1.86 ± 3.92
1.19 ± 1.84
0.42 ± 0.81
-7.148
0.001
cTn 2
5.02 ± 4.61
5.92 ± 6.12
2.43 ± 3.81
-8.101
0.001
cTn 3
11.81 ± 12.31
9.49 ± 12.74
4.57 ± 7.72
-7.361
0.001
BS, mg/dL
137.31 ± 60.49
136.94 ± 64.19
135.02 ± 63.44
-0.718
0.526
WBC, 103/μL
10.17 ± 3.31
9.89 ± 3.25
10.64 ± 3.82
-0.382
0.247
MCV, fL
88.23 ± 7.32
88.92 ± 7.42
88.48 ± 7.60
-0.249
0.642
MCH, pg
29.31 ± 2.31
29.43 ± 2.41
29.62 ± 2.38
-0.262
0.342
MCHC, g/dL
32.92 ± 0.81
32.96 ± 0.79
32.63 ± 0.72
-0.593
0.329
RDW, %
14.48 ± 2.12
15.42 ± 1.82
14.92 ± 2.48
-7.254
0.001
MPV, fL
8.53 ± 1.36
10.48 ± 3.47
8.96 ± 2.24
-2.823
0.019
Neu, %
6.25 ± 3.56
7.42 ± 1.44
6.82 ± 2.31
-14.762
0.001
Lymph, %
2.13 ± 1.12
2.32 ± 1.21
2.02 ± 1.19
-0.667
0.422
Table 2 χ2 analysis of acute coronary syndrome according to R to S ratio variables
Patients with
χ2
P-value
RSR > 1, n (%)
RSR < 1, n (%)
Sex, Male/Female
255/109 (19.7/8.4)
575/357 (44.4/27.5)
6.6
0.001
Diagnosis
UA
78 ( 6.9)
424 (32.7)
284.12
0.001
AIMI
184 (14.2)
65 (5.0)
AAMI
61 (4.7)
263 (20.3)
NSTEMI
40 (3.1)
180 (13.9)
Complication
No
114 (8.9)
524 (40.5)
89.23
0.001
IHF
151 (11.7)
251 (19.4)
VT
16 (1.2)
66 (5.1)
AV Block
43 (3.1)
21 (1.7)
PE/CT
9 (0.7)
18 (1.3)
APE
37 (2.5)
46 (3.9)
Tree-vessel Disease
No
253 (19.6)
733 (56.5)
10.03
0.001
Yes
111 (8.5)
199 (15.3)
Mortality
No
292 (22.5)
845 (65.2)
24.39
0.001
Yes
72 (5.6)
87 (6.7)
Table 3 χ2 analysis of acute coronary syndrome according to diagnostic variables
Diagnosis
UA, n (%)
AIMI, n (%)
AAMI, n (%)
NSTEMI, n (%)
χ2
P-value
Complication
No
388 (29.8)
102 (7.8)
76 (5.9)
74 (5.7)
384.01
0.001
IHF
72 (5.5)
76 (5.9)
176 (13.6)
78 (6.0)
VT
11 (0.8)
8 (0.6)
41 (3.2)
22 (1.7)
AV Block
9 (0.7)
47 (3.6)
4 (0.3)
4 (0.3)
PE/CT
9 (0.7)
5 (0.4)
6 (0.5)
7 (0.5)
APE
14 (1.1)
12 (0.9)
45 (3.5)
12 (0.9)
TVD
No
497 (38.3)
193 (14.9)
156 (12.9)
139 (10.7)
293.61
0.001
Yes
5 (0.4)
56 (4.3)
192 (14.8)
58 (4.4)
Mortality
No
485 (37.4)
207 (16)
280 (21.6)
165 (12.7)
56.73
0.001
Yes
17 (1.3)
42 (3.2)
68 (5.2)
32 (2.5)
Table 4 χ2 analysis of acute coronary syndrome according to blocked major coronary artery variables
Complication
TVD
Mortality
No, n (%)
IHF, n (%)
VT, n (%)
AV Block, n (%)
PE/CT, n (%)
APE, n (%)
No, n (%)
Yes, n (%)
No, n (%)
Yes, n (%)
RCA
128 (9.8)
74 (5.7)
11 (0.8)
24 (1.8)
6 (0.4)
5 (0.4)
165 (12.7)
184 (14.2)
243 (20)
37 (2.8)
R1
23 (1.8)
8 (0.7)
0 (0)
6 (0.4)
0 (0)
1 (0.1)
26 (2)
47 (3.6)
26 (2)
4 (0.3)
R2
32 (2.5)
12 (0.9)
0 (0)
3 (0.2)
1 (0.1)
0 (0)
32 (2.5)
45 (3.4)
36 (2.7)
1 (0.1)
R3
34 (2.6)
15 (1.1)
1 (0.1)
4 (0.3)
0 (0)
1 (0.1)
46 (3.5)
23 (1.8)
45 (3.5)
4 (0.3)
R4
18 (1.4)
11 (0.8)
0 (0)
1 (0.1)
1 (0.1)
5 (0.4)
29 (2.2)
11 (0.8)
33 (2.5)
7 (0.5)
L
74 (5.7)
6 (0.4)
14 (1)
9 (0.8)
4 (0.3)
5 (0.4)
81 (6.2)
47 (3.6)
75 (5.7)
17 (1.3)
L1
78 (6.2)
127 (9.8)
18 (6)
5 (0.4)
5 (0.4)
23 (1.8)
93 (7.1)
169 (13)
192 (14.8)
31 (2.4)
L2
133 (10.3)
119 (9.1)
16 (1.2)
7 (0.5)
7 (0.6)
19 (1.5)
181 (14)
94 (7.2)
269 (20.7)
43 (3.3)
L1A
37 (2.8)
4 (0.3)
13 (1)
1 (0.1)
0 (0)
12 (0.9)
163 (12.3)
7 (0.6)
53 (4.1)
7 (0.5)
L1B
23 (1.8)
8 (0.7)
4 (0.3)
2 (0.1)
0 (0)
4 (0.3)
42 (2.1)
4 (0.3)
37 (2.8)
1 (0.1)
L1C
12 (0.9)
2 (0.1)
5 (0.4)
1 (0.1)
0 (0)
2 (0.1)
27 (2)
4 (0.3)
23 (1.8 )
4 (0.3)
L2A
43 (3.3)
9 (0.8)
2 (0.1)
0 (0)
2 (0.1)
5 (0.4)
61 (4.7)
6 (0.5)
58 (4.5)
9 (0.8)
L2B
22 (1.7)
4 (0.3)
1 (0.1)
0 (0)
1 (0.1)
1 (0.1)
30 (2.3)
6 (0.5)
32 (2.5)
0 (0)
L2C
8 (0.6)
3 (0.2)
1 (0.1)
1 (0.1)
0 (0)
0 (0)
14 (11.)
2 (0.1)
15 (1.1)
1 (0.1)
χ2
1631.09
102.32
19.51
P-value
0.001
0.001
0.001
Table 5 Univariate and multivariate Cox regression analyses for predicting the development of R to S ratio
Univariate
Multivariate
Correlation
HR
95%CI
P-value
HR
95%CI
P-value
r
P-value
LVEF
0.964
0.919-0.933
0.001
0.945
0.896-0.410
0.001
-0.431
0.001
Mortality
3.924
2.748-5.708
0.001
1.463
0.989-2.219
0.004
0.242
0.001
TVD
2.197
1.592-2.911
0.001
3.471
1.419-7.133
0.001
0.189
0.001
cTn I
1.992
1.592-2.911
0.001
1.983
1.398-2.789
0.001
0.372
0.001
cTn II
1.145
1.117-1.189
0.001
1.278
1.233-1.491
0.001
0.326
0.001
cTn III
1.161
1.146-1.275
0.001
0.898
0.889-0.979
0.001
0.258
0.001
RDW
0.991
0.925-1.146
0.002
0.892
0.797-0.919
0.001
0.267
0.001
GS
1.109
1.102-1.114
0.001
0.996
0.986-1.005
0.386
0.208
0.001
Complication
1.368
1.322-1.469
0.001
0.993
0.989-1.178
0.752
0.267
0.001
Age
1.015
0.996-1.019
0.432
1.031
0.984-1.029
0.842
0.062
0.022
Gender
1.078
0.799-1.382
0.761
0.847
0.552-1.284
0.419
0.019
0.017
Citation: Coşkun A, Eren SH. R/S ratio in lead II, and the prognostic significance of red cell distribution width in acute coronary syndrome. World J Clin Cases 2019; 7(16): 2217-2226