Abstract: Objective To investigate the relationship between the red blood cell distribution width (RDW), high sensitivity C-reactive protein (hs-CRP) and the severity of coronary artery disease in elderly patients with acute coronary syndrome (ACS). Methods A total of 178 elderly patients with ACS were enrolled. They were first hospitalized at the Xuanwu Hospital from January 2010 to April 2014, their coronary culprit lesion was improved by Gensini score, according to the results of coronary angiography. Based on the Gensini score, the patients were further divided into mild lesion group (<50 points) in 48 cases, moderate lesion group (50 to 100 points)in 69 cases, severe disease group (≥100 points) in 61 cases; There were 38 cases without coronary disease were enrolled as normal control group. All patients were tested for their RDW and hs-CRP after admission.Results ①RDW and hs-CRP were significantly higher in the elderly patients with ACS than in the control group, the difference is statistically significant (F=7.312, P=0.008;F=5.249, P=0.026); ②Using Gensini score as dependent variable, Logistic regression analysis showed that RDW and hs-CRP were independent predictors for the severity of coronary artery lesion(OR=2.014, 95%CI:1.736~3.794; OR=1.896, 95%CI:1.492~3.989); ③RDW and hs-CRP levels were positively correlated (r= 0.21, P<0.05) in elderly patients with ACS. Conclusion ①RDW and hs-CRP seem to be independent predictors for the severity of coronary artery lesion. ②The mechanism of elevated RDW may be related to chronic inflammation. RDW and hs-CRP can be used as markers for clinical evaluation of severity of coronary artery disease and may be used for risk stratification in elderly patients with ACS, which are simple, inexpensive, and practical.

Key words: elderly, acute coronary syndrome, red blood cell distribution width, high sensitivity C-reactive protein, Gensini score