• Ana T Timóteo, Ana L Papoila, Ana Lousinha, Marta Alves, Fernando Miranda, Maria L Ferreira, and Rui C Ferreira.
• Cardiology Department, Santa Marta Hospital, Centro Hospitalar Lisboa Central, Portugal ana_timoteo@yahoo.com.
• Eur Heart J Acute Cardiovasc Care. 2015 Apr 1; 4 (2): 172-9.

BackgroundRed Cell Distribution Width (RDW) prognostic value in patients with Acute Coronary Syndrome (ACS) has been well validated whereas that of Platelet Distribution Width (PDW) is less well known.ObjectivesInvestigate the incremental prognostic value, on top of GRACE risk score, of a new variable resulting from the combination of RDW and PDW.MethodsConsecutive patients with ACS. Complete blood count, with RDW and PDW, was obtained. Primary endpoint was one-year all-cause mortality and Cox regression models were used to measure the influence of RDW and PDW on patients' survival time. A new combination categorical variable (RDW/PDW) was created with both discretized RDW and PDW and logistic regression models were used. Predictive value and discriminative ability of the model with GRACE risk score alone and of the model with inclusion of RDW/PDW was assessed.ResultsWe included 787 patients. Hospital and one-year mortality rates were 5.1% and 7.8%, respectively. Both continuous RDW and PDW were independent predictors of death. The best cut-off for RDW was 13.9%, and 14.5% for PDW. Inclusion of RDW/PDW in a model with GRACE risk score improved the AUC from 0.81 (95% CI 0.75-0.86) to 0.84 (95% CI 0.79-0.90) (p=0.024) with an improvement in total NRI (56%) and IDI (0.048).ConclusionsSimple markers such as RDW and PDW can be useful in risk stratification of death after ACS. Combining both markers with GRACE risk score improved the predictive value for all-cause mortality and reduced the estimated risk of those who did not die.© The European Society of Cardiology 2014.

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