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Prognostic value of red cell distribution width in patients undergoing percutaneous coronary intervention: a
Donglai Bao1, Gaojiang Luo2, Fuqiang Kan2
1Department of Cardiovascular disease, Yiwu Central Hospital, Yiwu, China baodlyw01@tom.com.
Insights
Elevated red cell distribution width (RDW) is linked to increased mortality and adverse cardiac events in coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI). This association is stronger in patients without anemia, suggesting RDW as a prognostic biomarker.
Area of Science:
- Cardiology
- Clinical Biomarkers
- Medical Statistics
Background:
- Coronary artery disease (CAD) remains a leading cause of mortality worldwide.
- Percutaneous coronary intervention (PCI) is a common revascularization strategy for CAD.
- Identifying reliable prognostic markers in patients undergoing PCI is crucial for risk stratification.
Purpose of the Study:
- To evaluate the prognostic value of baseline red cell distribution width (RDW) in patients with CAD undergoing PCI.
- To determine the association between elevated RDW and outcomes such as all-cause mortality, cardiovascular mortality, and major adverse cardiac events (MACEs).
Main Methods:
- A systematic review and meta-analysis of studies published up to June 19, 2019.
- Searched multiple databases including PubMed, Embase, Wanfang, CNKI, and VIP.
- Included 12 studies (13 articles) with 17,113 patients, analyzing baseline RDW for predicting mortality and MACEs using random-effect models.
Main Results:
- Elevated baseline RDW was significantly associated with increased risk of all-cause mortality (RR 1.77), cardiovascular mortality (RR 1.70), and MACEs (RR 1.62).
- The predictive value of RDW for all-cause mortality was notably stronger in patients without anemia (RR 4.59) compared to those with anemia.
- Forest plots were generated using STATA V.12.0 software to visualize pooled risk ratios.
Conclusions:
- Elevated red cell distribution width is a significant predictor of mortality and adverse cardiac events in patients with CAD undergoing PCI.
- RDW demonstrates a stronger prognostic capability for all-cause mortality in non-anemic patients undergoing PCI.
- Baseline RDW emerges as a promising and accessible prognostic biomarker for risk assessment in patients undergoing PCI.
Objective:
To evaluate the prognostic value of baseline red cell distribution width (RDW) in patients with coronary artery diseases (CADs) undergoing percutaneous coronary intervention (PCI) by conducting a meta-analysis.
Design:
Systematic review and meta-analysis.
Data Source:
PubMed, Embase, Wanfang, CNKI and VIP databases were searched from their inceptions to 19 June 2019.
Eligible Criteria:
Studies investigating the value of baseline RDW for predicting all-cause mortality, cardiovascular mortality and major adverse cardiac events (MACEs) in patients with CAD undergoing PCI were included.
Data Extraction And Synthesis:
Two authors independently extracted the data and evaluated the methodological quality using the Newcastle-Ottawa Scale. STATA V.12.0 software was applied to produce the forest plots using a random-effect model.
Results:
Twelve studies (13 articles) involving 17 113 patients were included and analysed. Comparison between the highest and lowest RDW category indicated that the pooled risk ratio (RR) was 1.77 (95% CI 1.32 to 2.37) for all-cause mortality, 1.70 (95% CI 1.25 to 2.32) for cardiovascular mortality and 1.62 (95% CI 1.21 to 2.18) for MACEs. The predictive effect of elevated RDW for all-cause mortality was stronger in the subgroup of patients without anaemia (RR 4.59; 95% CI 3.07 to 6.86) than with anaemia.
Conclusions:
This meta-analysis indicated that elevated RDW was associated with higher risk of mortality and adverse cardiac events in patients with CAD undergoing PCI. The value of elevated RDW for predicting all-cause mortality appears to be stronger in patients without anaemia. RDW may be served as a promising prognostic biomarker in patients undergoing PCI.
