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Red blood cell distribution width and myocardial scar burden in coronary artery disease
  1. Caroline Jane Magri1,2,
  2. Tan Xiao Tian3,
  3. Liberato Camilleri4,
  4. Robert Xuereb1,2,
  5. Joseph Galea2,5,
  6. Stephen Fava2,3
  1. 1 Department of Cardiology, Mater Dei Hospital, Msida, Malta
  2. 2 University of Malta Medical School, University of Malta, Tal-Qroqq, Msida, Malta
  3. 3 Department of Medicine, Mater Dei Hospita, Tal-Qroqq, Msida, Malta
  4. 4 Statistics & Operations Research, Faculty of Science, University of Malta, Msida, Malta
  5. 5 Department of Cardiac Services, Mater Dei Hospital, Tal-Qroqq, Msida, Malta
  1. Correspondence to Dr Caroline Jane Magri, Cardiac Catheterisation Suite, Department of Cardiology, Mater Dei Hospital, Tal-Qroqq, Msida MSD 2090, Malta; caroline.j.magri{at}


Introduction Red blood cell distribution width (RDW) is a novel independent marker of cardiovascular disease including heart failure, coronary artery disease and myocardial ischaemia. The aim of the study was to investigate a possible relationship between RDW and myocardial scar burden, as assessed by a MIBI viability scan. A secondary objective was to assess whether there is an association between RDW and left ventricular ejection fraction (LVEF).

Methods The study comprised 123 subjects with ischaemic heart disease who underwent a myocardial viability scan between June 2008 and July 2014. Haemoglobin, mean corpuscular volume, RDW, platelet count, mean platelet volume (MPV), estimated glomerular filtration rate, fasting blood glucose, liver and lipid profiles were evaluated for all patients. The extent of myocardial scarring and LVEF were noted. Data were analysed using IBM SPSS Statistics 22.0. Univariate followed by multivariate analyses were performed to assess for independent predictors of myocardial scarring and LVEF, respectively.

Results The mean age of the study population was 63.5 years; most of the subjects were men. The median LVEF was 31% and median percentage of myocardial scarring was 8.7%. Multivariate analyses revealed that RDW, HDL-cholesterol and alanine transaminase were independent predictors of myocardial scarring while RDW, MPV, LDL-cholesterol and gamma-glutamyl transpeptidase were independent predictors of LVEF.

Conclusions Increased RDW is an independent predictor both of myocardial scar burden and of impaired left ventricular function in subjects with coronary artery disease.

  • Coronary heart disease < CARDIOLOGY
  • Cardiovascular imaging < RADIOLOGY & IMAGING

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  • Contributors CJM designed the study, analysed the data and drafted the manuscript. TXT contributed to data collection. LC assisted with statistical analysis. RX, JG and SF contributed to data interpretation and critically revised the paper. SF was involved in the design of the study. All co-authors gave final approval to manuscript submission. CJM is the guarantor of the data and results presented.

  • Competing interests None declared.

  • Ethics approval University of Malta Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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