Red Blood Cell Distribution Width: A Novel Predictive Indicator for Cardiovascular and Cerebrovascular Diseases

Table 5

Studies exploring association between red blood cell distribution width (RDW) and atrial fibrillation (AF).

First author, journal, year	Study design	Study population	Mean follow-up	Major outcomes	Major limitations
(i) Adamsson et al. [130]; (ii) Journal of Internal Medicine; (iii) 2013	Prospective cohort study	27,124 subjects from the general population with no history of atrial fibrillation, myocardial infarction, heart failure or stroke. Age 45–73 years	13.6 years	HR for incidence of atrial fibrillation was 1.33 (95% CI 1.16–1.53) for the fourth versus first quartile of RDW ()	(i) The study did not have information on HbA1c and lipid levels for the entire cohort; (ii) Some cases of atrial fibrillation might be treated only in primary care and therefore would not be included in this study; (iii) No detailed information about the AF cases at the time of diagnosis
(i) Chaikriangkrai et al. [131]; (ii) African Health Sciences; (iii) 2014	Retrospective analysis	(i) 63 hypertensive patients with atrial fibrillation, age 71.09 ± 8.50 years; (ii) 63 hypertensive patients without atrial fibrillation, age 70.97 ± 8.24 years	—	RDW level was different among patients with atrial fibrillation and without atrial fibrillation (15.13 ± 1.58 and 14.05 ± 1.15, ).	(i) The sample size was relatively small; (ii) Echocardiographic parameters were not obtained concomitantly with blood sampling
(i) Güngör et al. [132]; (ii) Journal of Thrombosis and Thrombolysis; (iii) 2014	Retrospective study	117 non-valvular AF patients including 103 paroxysmal and 14 chronic atrial fibrillation, aged > 18 years	—	RDW (OR 4.18, 95% CI: 2.15–8.15; ), hs-CRP (OR 3.76, 95% CI: 1.43–9.89; ) and left atrial volume (OR 1.31, 95% CI: 1.06–1.21; ) as the independent markers of non-valvular atrial fibrillation	(i) The study population was small; (ii) The study did not assess specific markers of oxidative stress; (iii) No detailed information about the AF cases at the time of diagnosis
(i) Gurses et al. [55]; (ii) Journal of Interventional Cardiac Electrophysiology; (iii) 2015	Prospective study	299 patients with symptomatic paroxysmal or persistent atrial fibrillation despite ≥1 antiarrhythmic drug(s), age 55.40 ± 10.60 years	24 months	(i) Patients with late atrial fibrillation recurrence had higher RDW levels (14.30 ± 0.93 versus 13.52 ± 0.93%, ); (ii) RDW level was an independent predictor for late AF recurrence (HR 1.88, 95% CI: 1.41–2.50, )	(i) The study population was small; (ii) Not illustrate the accurate mechanism
(i) Chaikriangkrai et al. [131]; (ii) International Journal of Cardiology; (iii) 2015	Pilot study	109 patients undergoing cardiac surgery, age 66.9 ± 9.5 years	—	RDW was the only independent predictor of postoperative atrial fibrillation (OR: 1.46; 95% CI: 1.078–1.994; ). A RDW cut-off point of 13.35 was related to postoperative atrial fibrillation with a sensitivity of 80% and a specificity of 60%	(i) The study population was small; (ii) The study did not assess specific markers of oxidative stress; (iii) Only baseline values were recorded
(i) Korantzopoulos and Liu [133]; (ii) Journal of Cardiology; (iii) 2016	Retrospective study	101 patients with symptomatic SSS undergoing dual-chamberpacemaker implantation, median age 77 years	—	Left atrial diameter was increased in tachy-brady patients (44 mm versus 39 mm; ). Also, the RDW was greater in these patients (14.7% versus 13.7%; )	(i) The study population was small; (ii) The author did not assess the AF risk and atrial fibrillation burden after pacemaker implantation using the device diagnostics; (iii) The author did not assess specific novel markers of oxidative stress and inflammation