Cureus. 2026 Aug 5;18(8):e114035. doi: 10.7759/cureus.114035. eCollection 2026 Aug.
ABSTRACT
BACKGROUND: Acute coronary syndrome (ACS) is a major cause of cardiovascular morbidity and mortality. Red cell distribution width-coefficient of variation (RDW-CV), a routinely available complete blood count parameter, has emerged as a potential prognostic marker in cardiovascular diseases.
AIM AND OBJECTIVE: This study aimed to assess the prognostic significance of RDW in patients with ACS.
MATERIALS AND METHODS: This prospective observational study was conducted in the Department of Medicine at Bundelkhand Medical College and Hospital, Sagar, Madhya Pradesh, India. A total of 210 patients diagnosed with ACS were included. Demographic details, risk factors, clinical history, RDW-CV, red cell distribution width-standard deviation (RDW-SD), ECG findings, troponin I status, Killip class, Global Registry of Acute Coronary Events (GRACE) score, hospital stay, and mortality were analyzed. Statistical analysis was performed using IBM SPSS Statistics software, version 25 (IBM Corp., Armonk, NY, USA), and p<0.05 was considered statistically significant.
RESULTS: Among 210 patients, 141 (67.10%) were male, and 69 (32.85%) were female. The mean age was 57.49 ± 12.45 years, and most patients belonged to the 40-60-year age group, 105 (50.00%). Smoking was reported in 48 patients (22.85%), followed by hypertension in 47 (22.40%) and diabetes mellitus in 45 (21.42%). On Day 1, RDW-CV was elevated in 111 patients (52.86%). In-hospital mortality occurred in 10 patients (4.8%); nine out of 111 patients (8.1%) in the high RDW-CV group and one out of 99 patients (1.0%) in the low RDW-CV group died, showing a significant association between elevated RDW-CV and mortality (p<0.05). Mean RDW-CV increased progressively with higher Killip class, from 13.8 ± 2.1 in Class I to 16.6 ± 1.6 in Class IV (p < 0.001). GRACE scores also increased significantly with higher Killip class (p < 0.0001).
CONCLUSION: RDW-CV was significantly associated with mortality, Killip class, and GRACE score in patients with ACS. It may serve as a simple, inexpensive, and routinely available prognostic marker for assessing disease severity and clinical outcome in ACS patients.
PMID:42701377 | PMC:PMC13545018 | DOI:10.7759/cureus.114035