Objective To study the relationship between red cell distribution width (RDW ) and short-term outcomes in acute coronary syndrome (ACS) patients .Methods A totoal of 1654 ACS patients were divided into RDW ≤12 .1% group(n=419) ,RDW=12 .2% -12 .8% group(n=364) ,RDW=12 .9% -13 .2% group (n= 463) and RDW ≥13 .3% group (n= 408) .Their bio-chemical indicators and incidence of 1-month cardiac death ,heart failure ,recurrent myocardiac in-farction were compared .Relationship between RDW and 1-month adverse cardiac events was as-sessed .Results The incidence of cardiac death ,heart failure ,recurrent myocardiac infarction in-creased with the increasing RDW .Logistic regression analysis showed that RDW ,BNP>100 ng/L and LVEF< 40% were the independent risk factors for 1-month cardiac death in ACS patients (OR=2 .116 ,95% C I:1 .427-3 .137 ,P=0 .000;OR=3 .510 ,95% C I:1 .221 -10 .093 ,P=0 .020 ;OR= 4 .149 ,95% CI:2 .001 -8 .602 ,P= 0 .000 ) ,and that RDW ,age> 65 years ,diabetes and LVEF<40% were the independent risk factors for 1-month heart failure and recurrent myocardi-ac infarction in ACS patients (OR= 2 .134 ,95% CI:1 .602 -2 .844 ,P= 0 .000 ,OR= 2 .010 , 95% C I:1 .135 -3 .560 ,P=0 .017 ;OR=2 .279 ,95% C I:1 .345 -3 .862 ,P= 0 .002 ;OR=5 .009 , 95% CI:2.694-9 .316 ,P=0 .000) .Conclusion RDW is an independent risk factor for the short-term outcomes in ACS patients .%目的：探讨红细胞体积分布宽度（RDW ）与急性冠状动脉综合征（ACS ）患者近期预后的关系。方法选择ACS患者1654例，根据基线RDW四分位数分为≤12．1％组419例、12．2％～12．8％组364例、12．9％～13．2％组463例和≥13．3％组408例。比较各组生化指标、1个月时心源性死亡、心力衰竭及再次心肌梗死发生率。评估RDW与1个月时恶性事件的关系。结果随着RDW逐步升高，心源性死亡、心力衰竭及再次心肌梗死发生率也逐步升高。logistic回归分析显示，RDW（OR＝2．116，95％ CI：1．427～3．137，P＝0．000）、B型钠尿肽＞100 ng/L （OR＝3．510，95％ CI：1．221～10．093，P＝0．020）、LVEF＜40％（OR＝4．149，95％ CI：2．001～8．602，P＝0．000）是ACS患者1个月时心源性死亡的独立危险因素。同时，RDW（OR＝2．134，95％ CI：1．602～2．844，P＝0．000）、年龄＞65岁（OR＝2．010，95％ C I：1．135～3．560，P＝0．017）、糖尿病（OR＝2．279，95％ C I：1．345～3．862，P＝0．002）和LVEF＜40％（OR＝5．009，95％ CI：2．694～9．316，P＝0．000）是1个月时心力衰竭及再次心肌梗死发生的独立危险因素。结论 RDW是ACS患者近期预后的独立危险因素。
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