Red cell distribution width: a novel predictive biomarker for stroke risk after transient ischaemic attack

Area of Science:

• Neurology
• Hematology
• Clinical Diagnostics

Background:

• Predicting prognosis after transient ischaemic attack (TIA) is challenging for clinicians.
• Identifying reliable biomarkers for early stroke risk stratification in TIA patients is crucial.

Purpose of the Study:

• To investigate the predictive value of red blood cell distribution width (RDW) for subsequent stroke in patients with TIA.
• To assess RDW's ability to differentiate between TIA, ischaemic stroke (IS), and haemorrhagic stroke (HS).

Main Methods:

• Analysis of 360 consecutive new-onset TIA patients.
• Categorization into TIA, IS (within 7 days), and HS (within 7 days) groups.
• Comparison of RDW values and diagnostic performance against ABCD² scores.

Main Results:

• Mean RDW values were significantly higher in IS and HS patients compared to TIA-only patients (p ≤ .001).
• RDW was independently associated with IS (OR=2.52) and HS (OR=1.51) post-TIA.
• RDW demonstrated superior diagnostic power for IS prediction compared to ABCD² scores (AUC 0.731 vs 0.613, p=.015).

Conclusions:

• RDW is a promising, rapid, easy, and inexpensive biomarker for predicting stroke post-TIA, particularly IS.
• A baseline RDW of ≥13.95% indicated a 2.52-fold risk of IS, and ≥12.85% indicated a 1.51-fold risk of HS.
• RDW serves as a valuable biomarker for risk stratification in TIA patients due to its accessibility and cost-effectiveness.