The Impact of Complete Blood Count-Derived Indices (RDW, PDW and NLR) on 4 Years Outcomes in Patients after PCI with Sirolimus-Eluting Stent, including Complex High-Risk Index Procedure (CHIP) Patients

Background We analyzed red cell distribution width (RDW), platelet distribution width (PDW), and the neutrophil-to-lymphocyte ratio (NLR) as potential predicting factors of adverse outcomes in patients after percutaneous coronary intervention (PCI) at 48 months follow-up. Material and methods We gathered data on subjects who underwent PCI with a sirolimus-eluting Alex Plus stent (Balton, Poland). We characterized the rate of major adverse cardiovascular events (MACE) over a 4-year period, which encompassed cardiac death, myocardial infarction (MI), and target lesion revascularization (TLR) depending on the RDW, PDW, and NLR values. Results We included 218 patients (256 stents), among which we also identified 77 complex, high-risk index procedure (CHIP) patients and 73 high bleeding risk (HBR) patients. We identified only RDW as having a significant impact on long-term outcomes and only in the total population and CHIP patients. The total population with RDW > 14.5% was characterized by higher age (67±11 vs. 73±10 years, p < 0.01) and higher incidence of chronic kidney disease (14% vs. 39%, p < 0.01) as well as chronic obstructive pulmonary disease (4% vs. 15%, p=0.024). Interestingly, this group had a lower rate of ACS (42% vs. 34%, p=0.049). At 48 months in the total population with RDW > 14.5% patients, the rates of MACE, cardiac death, MI, and TLR were 26.8%, 19.5%, 9.8%, and 12.2%, respectively. Conclusions RDW > 14.5% correlated with a higher risk of cardiac death in the total population and CHIP patients