Author(s): Su C, Liao LZ, Song Y, Xu ZW, Mei WY
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Abstract BACKGROUND: Red cell distribution width (RDW) might be a novel biomarker that reflects multiple physiological impairments related to atherosclerosis and coronary artery diseases (CAD). We conducted this systematic review and meta-analysis to evaluate the association of RDW between all-cause mortality and fatal/non-fatal cardiovascular disease (CVD) events in CAD patients. METHODS: Relevant studies were searched and identified in the MEDLINE and EMBASE databases. English-language prospective studies that reported risk estimates for RDW and mortality/CVD events were included. Data were extracted regarding the characteristics and clinical outcomes, and a quality assessment was conducted. Results were extracted for the highest versus lowest RDW level, and meta-analyses were carried out using random effects models. RESULTS: We identified 22 studies enrolling 80,216 participants. The study duration ranged between 1 month and 23 years. Of the 15 studies that were included in the meta-analysis, higher RDW indicated a significant increased risk for all-cause mortality in CAD patients: pooled risk ratio (RR) 2.20 (95\% CI, 1.42-3.39; P<0.0004). The results for fatal, non-fatal and fatal/non-fatal events were: pooled RR 1.80 (95\% CI, 1.35-2.41; P<0.0001), RR 1.86 (95\% CI, 1.50-2.31; P<0.00001) and RR 2.13 (95\% CI, 1.20-3.77; P=0.01). Heterogeneity was moderately present; however, sensitivity analyses for follow-up duration, CAD subtype, or RDW as dichotomous values showed similar results. CONCLUSIONS: The meta-analysis indicates that higher RDW levels are associated with increased risk of mortality and CVD events in patients with established CAD.
This article was published in J Thorac Dis
and referenced in Journal of Sleep Disorders & Therapy