Red Blood Cell Distribution Width and Stent Length Predict In-Stent Restenosis After Myocardial Infarction: A Retrospective Cohort Study

Summary

This study evaluated whether red blood cell distribution width and stent length predict in-stent restenosis after percutaneous coronary intervention using regression analysis and found that their combination improves predictive accuracy.

Abstract

This study investigated the predictive value of red blood cell distribution width (RDW) stent length for in-stent restenosis (ISR) drug-eluting stent implantation in patients with acute myocardial infarction. Reliable predictors of restenosis remain limited, highlighting the need for accessible clinical markers. A total of 170 patients who underwent stent implantation were included and classified into restenosis and nonrestenosis groups based on follow-up coronary angiography at 12 months. Clinical characteristics and laboratory parameters were compared between groups. Multivariate logistic regression and receiver operating characteristic analyses were performed to evaluate associations and predictive performance. The results showed that RDW and stent length were significantly higher in patients with restenosis and were independent predictors of restenosis risk. The combined use of these variables demonstrated improved predictive performance compared to using the variables individually. In conclusion, RDW and stent length are significant predictors of ISR and may serve as practical indicators for risk stratification in patients undergoing stent implantation.

Introduction

Percutaneous coronary intervention (PCI) is an important method for revascularization in patients with coronary heart disease. Emergency PCI is a crucial treatment approach for patients with acute ST-segment elevation myocardial infarction (STEMI)¹, and can significantly reduce the mortality rate of myocardial infarction². Although the implantation of drug-eluting stents has reduced the incidence of in-stent restenosis (ISR), this complication remains unresolved.

In recent years, red blood cell distribution width (RDW) has received increasing attention as a marker of inflammation in cardiovasc....

Protocol

This study was approved by the Ethics Committee of Chengdu Second People’s Hospital (Approval No. KYPJ2025553) and conducted in accordance with the Declaration of Helsinki. The requirement for informed consent was waived due to the study’s retrospective design.

A schematic of the study workflow (including patient selection, grouping, and analysis pipeline) is shown in Figure 1.

Results

Incidence of ISR and Baseline Characteristics
A total of 170 patients with STEMI who underwent emergency PCI and stent implantation were followed for 12 months, and all patients underwent coronary angiography re-examination. Among them, 32 patients developed ISR, while 138 patients did not develop ISR and served as the comparison (non-ISR) group. The baseline characteristics of the two groups were comparable, with no significant differences observed. However, stent length was greater in the ISR group.......

Discussion

Previous studies have demonstrated the prognostic significance of RDW in various cardiovascular diseases. In the present study, RDW levels prior to intervention and stent length were independently associated with DES restenosis in patients with acute ST-segment elevation myocardial infarction. In addition, the combined use of these two indicators showed higher predictive efficacy than either parameter alone. These findings extend existing evidence by demonstrating the combined predictive value of RDW and stent length spe.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
	Philips	Azurion 7 M12	Coronary angiography imaging system used for diagnostic and follow-up angiography
	Mindray	BriCyte-E6	Hematology analyzer used for complete blood count and RDW measurement
	Hitachi, Japan	Hitachi 008 AS	Biochemical analyzer used for measurement of lipid profiles, creatinine, and albumin
	Medtronic	Resolute Integrity	Drug-eluting stent used for coronary stent implantation
	Boston Scientific	Promus Premier	Drug-eluting stent used for coronary stent implantation
	IBM	SPSS v27.0	Statistical software used for data analysis