Red Blood Cell Distribution Width: A Novel Predictive Indicator for Cardiovascular and Cerebrovascular Diseases
Table 2
Studies exploring association between red blood cell distribution width (RDW) and heart failure (HF).
First author, journal, year
Study design
Study population
Mean follow-up
Major outcomes
Major limitations
(i) Felker et al. [14]
(ii) Journal of the American College of Cardiology
(iii) 2007
Retrospective cohort
2679 symptomatic chronic heart failure patients, mean age ≥ 60 years
A median of 34 months
HR for morbidity and mortality (1 SD increment of RDW): 1.17 (95% CI, 1.03–1.20)
(i) Not provide a formal evaluation
(ii) Not focus on model performance
(i) Allen et al. [42]
(ii) Journal Cardiac Failure
(iii) 2010
Prospective, multicenter cohort
1016 heart failure patients, age 64 ± 14 years
At least 2 years
HR for hospitalization or mortality (1 SD increment of RDW): 1.06 (95% CI, 1.02–1.10)
(i) The mean follow-up was short at 1 year
(ii) The research cannot distinguish causality from association
(i) Borné et al. [43]
(ii) European Journal Heart Failure
(iii) 2011
Population-based cohort study
26,784 subjects, age 45–73 years, without history of heart failure, stroke or myocardial infarction
A mean of 15 years
HR for heart failure in the top quartile of RDW (1 SD increment of RDW): 1.47 (95% CI: 1.14–1.89)
(i) Lack of information on type and cause of heart failure
(ii) Biomarker data were only available for a subgroup
(i) Celik et al. [44]
(ii) The Kaohsiung Journal of Medical Sciences
(iii) 2012
Cross-sectional study
71 diastolic heart failure, age 57.09 ± 7.43 years and 50 control, age 56 ± 7 years
—
RDW > 13.6% and NT-proBNP > 125 pg/mL have high diagnostic accuracy in diastolic heart failure patients
(i) The sample size was relatively small
(ii) Not measure left ventricular pressures directly
(i) Dai et al. [45]
(ii) Experimental and Therapeutic Medicine
(iii) 2014
Prospective cohort
521 patients with acute congestive heart failure, mean age ≥ 60 years
A mean of 24 months
Higher RDW values in acute congestive heart failure patients at admission were more prognostically relevant than Hgb levels
(i) The sample size was relatively small
(ii) Not ensure that RDW is independent of Hgb levels
(i) Mawlana et al. [46]
(ii) ISRN Pediatrics
(iii) 2014
Cross-sectional study
31 children with heart failure, mean age 16.16 ± 14.97 months
—
RDW level was significantly related to hemoglobin level (), fraction shortening (FS) (), A (), and E/A ratio () in children patients
(i) The sample size was relatively small
(ii) No follow-up of the patient as regards
(iii) Frequent hospitalization and or death
(i) Al-Najjar et al. [47]
(ii) European Journal of Heart Failure
(iii) 2009
Prospective cohort
1087 patients referred to a community
HF clinic, age 64–78 years
52 months
Both RDW and NT-proBNP were independent prognostic (RDW: chi square 21.8 versus 49.1 both )
(i) Predictive power was examined only at a single time point
(ii) No information on mode of death nor on hospitalization
(iii) Not ensure that RDW is independent of EPO levels
(i) Rudresh and Vivek [48]
(ii) International Journal of Medical Research and Review
(iii) 2016
Cross-sectional study
70 heart failure patients, age 54. 86 ± 11.75 years and 30 control, age 52.03 ± 13.21 years
—
The mean RDW in patient was 15.763 ± 2.609 and in controls was 13.17 ± 0.75, respectively
(i) Not ensure that RDW is independent of EPO levels
(i) Sotiropoulos et al. [49]
(ii) ESC Heart Failure
(iii) 2016
Prospective cohort
402 acute heart failure without acute coronary syndrome, age 64–86 years
1 year
(i) All-causemortality of all patients increased with quartiles of rising RDW (chi square 18; )
(ii) In acute heart failure with LVEF ≥50%, the probability of all-cause mortality increased with rising RDW (; chi square 9.9; )
(i) Without consideration of cardiovascular mortality or rehospitalization rate
(ii) Echocardiograms were not obtained in all patients
(i) Liu et al. [50]
(ii) Medical Science Monitor
(iii) 2016
Retrospective analysis
179 chronic heart failure patients with different NYHA class, age 49–83 years
—
RDW increased significantly in class III and IV compared with class I (14.3 ± 2.3% and 14.3 ± 1.7% versus 12.9 ± 0.8%, )
(i) Only in-hospital baseline data were collected
(ii) Healthy controls were not recruited
