Prognostic value of red cell distribution width in patients undergoing percutaneous coronary intervention: a meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of prognostic cohort studies
PubMed 32912972 · doi:10.1136/bmjopen-2019-033378
What was done
A systematic review and meta-analysis evaluated the prognostic utility of baseline red cell distribution width (RDW) in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI). Five databases (PubMed, Embase, Wanfang, CNKI, VIP) were searched from inception to June 19, 2019. Quality was assessed using the Newcastle-Ottawa Scale, and pooled risk ratios (RRs) comparing the highest versus lowest RDW categories were calculated using random-effects models.
What was found
Across 12 studies (13 articles) encompassing 17,113 patients, elevated baseline RDW was significantly associated with higher risks of: - All-cause mortality: RR 1.77 (95% CI 1.32 to 2.37) - Cardiovascular mortality: RR 1.70 (95% CI 1.25 to 2.32) - Major adverse cardiac events (MACEs): RR 1.62 (95% CI 1.21 to 2.18) In subgroup analysis, the association between elevated RDW and all-cause mortality was stronger among non-anaemic patients (RR 4.59; 95% CI 3.07 to 6.86) than among anaemic patients.
Why it matters
Baseline RDW is an inexpensive and widely available marker that aids post-PCI risk stratification, showing particularly pronounced prognostic value for mortality in patients without anaemia.
Limits
The included studies were observational cohorts subject to residual confounding. The abstract does not report specific RDW thresholds, follow-up durations, between-study heterogeneity metrics, or the extent of multivariable adjustment across included studies.
Cited by
- supports Red cell distribution width (RDW) is an independent predictor of adverse clinical outcomes and mortality.