Clinical Trials Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2019; 7(16): 2217-2226
Published online Aug 26, 2019. doi: 10.12998/wjcc.v7.i16.2217
R/S ratio in lead II, and the prognostic significance of red cell distribution width in acute coronary syndrome
Abuzer Coşkun, Sevki Hakan Eren
Abuzer Coşkun, Department of Emergency, Sivas Numune Hospital, Sivas 58040, Turkey
Sevki Hakan Eren, Department of Emergency Medicine, Gaziantep University School of Medicine, Gaziantep 27310, Turkey
Author contributions: All authors helped to perform the research; Coşkun A wrote the manuscript, performed the procedures, and analysed the data; Eren SH wrote the manuscript, drafted the concept and design, performed the experiments, and analysed the data; Coşkun A contributed to writing the manuscript and drafting the concept and design; Coşkun A and Eren SH contributed to writing the manuscript; Coskun A contributed to writing the manuscript and drafting the concept and design.
Institutional review board statement: The study was approved by the Institutional Review Board.
Clinical trial registration statement: This registration policy applies to prospective, randomized, controlled trials only.
Informed consent statement: Written informed consent was not necessary because the study was performed retrospectively by screening patient files.
Conflict-of-interest statement: Not declared.
Data sharing statement: All data is available on request without restriction.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Abuzer Coşkun, MD, Associate Specialist, Doctor, Department of Emergency, Sivas Numune Hospital, Yesilyurt Mah. Sifa Street, Sivas 58000, Turkey. dr.acoskun44@hotmail.com
Telephone: +90-532-1577912 Fax: +90-346-2239530
Received: February 27, 2019
Peer-review started: February 27, 2019
First decision: April 18, 2019
Revised: June 26, 2015
Accepted: July 20, 2019
Article in press: July 20, 2019
Published online: August 26, 2019
Processing time: 179 Days and 22.8 Hours
ARTICLE HIGHLIGHTS
Research background

New cardiac biomarkers and techniques that will help to provide rapid diagnosis are needed in order to evaluate risk in coronary artery patients.

Research motivation

The aim of this study was to evaluate the significance of R/S ratio (RSR) in the lead II derivation of electrocardiography in acute coronary syndromes (ACS) patients, in regard to the complications associated with myocardial infarction, three-vessel coronary artery disease, and mortality.

Research objectives

If the research is supported by prospective studies, it may be a guide for patients with ACS in the future.

Research methods

Between January 2014 and December 2018, 1,296 patients with ACS were included in the study. The patients were referred to group I for an RSR value less than I, and to group II for an RSR value greater than I.

Research results

In our study, 466 (35.9%) of the 1,296 patients (357 (38.3%) in group I and 109 (29.9%) in group II) were female, with a mean age of 61.56 ± 9.42. ST-elevation MI 573 (44.2%), unstable angina (UA) 502 (38.7%) and non-ST-elevation MI 220 (17%) were more prevalent in group I. In group 1, acute anterior MI 263 (20.3), and in group II acute inferior MI 184 (14.2) was higher. Ischemic heart failure was the most common complication. In group II, the red cell distribution width (RDW) was 15.42 ± 1.82, the gensini score was 48.39 ± 36.44, the left ventricular ejection fraction was 41.17 ± 10.41, the three-vessel disease (TVD) was 111 (8.5), and the mortality rate was 72 (5.6), which was significantly higher than group I RDW; in MI with ST and non ST-elevation, in TVD, mortality and complications was high and was low in UA. In single and multivariate regression analyses, the variables were associated with ACS risk.

Research conclusions

RSR levels may be an auxiliary predictive value in ACS in terms of complications developing after myocardial infarction, TVD, and mortality.

Research perspectives

R/S ratio, red cell distribution width.