Red cell distribution width and inflammatory markers in patients with angiographically confirmed coronary artery disease

Lipid accumulation and inflammation in the vessel wall play the most important roles in atherosclerosis and perpetuate atherosclerotic plaque development. Mediators of inflammation as fibrinogen and interleukin 6 (IL-6) may contribute to the exacerbation of atherosclerosis. Red cell distribution width (RDW) is a strong predictor of cardiovascular events. The aim of the present study was to compare RDW, serum levels of fibrinogen and IL-6 in patients with angiographically confirmed coronary artery disease according to the disease extension. We enrolled 201 patients with angiographically confirmed coronary artery disease that were divided in three groups by the extent of the atherosclerotic lesion of the coronary arteries: 126 patients with monovascular affection (group A: mean age 59.1±9.84 years), 42 with bivascular affection (group B: mean age 59.1±9.65 years) and 33 with trivascular affection (group C: mean age 64.0±8.81 years). We measured RDW, fibrinogen and IL-6 levels in all patients. We obtained significantly increased mean values of fibrinogen and IL-6 in trivascular compared to bivascular, monovascular and control groups (all p <0.001). We also obtained significantly increased mean values of RDW in trivascular group compared to bivascular, monovascular and control groups (all p<0.001). A significantly correlation between IL-6 and RDW (r=0.485, p<0.001) was found. Our study showed that increased levels of RDW, fibrinogen and Il-6 are associated with severe extension of angiographically confirmed coronary artery disease. The correlation between Il-6 and RDW values explains that high levels of RDW could reflect an underlying inflammatory state causing anisocytosis.