Article Test

Objective: Increased red cell distribution width (RDW) has been associated with poor prognosis in patients with heart failure (HF) and coronary heart disease (CHD) in multiple observation studies. We conducted this meta-analysis to determine composite impact of RDW on cardiovascular outcomes in patients with HF and CHD.

Methodology: Literature search of databases such as PubMed/Medline, Google Scholar, and Cochrane library was conducted from inception till 16 th August, 2020 to identify all the relevant studies reporting all-cause mortality based on the RDW levels in patients with HF and CHD (ST- elevation & non-ST elevation myocardial infarction, coronary artery disease). The data was extracted from retrieved results for performing this systematic review and meta-analysis.

Results: A total of 32 studies were included with a total of 58, 518 patients. The ages ranged from 49-80 years with males being 47%–98% in proportion. We observed that the pooled estimate of hazard ratio (HR) for all-cause mortality among patients with congestive heart failure (CHF) was 1.16 (95% CI 1.10–1.23; p <0.001), and the pooled HR for all-cause mortality among CHD patients was 1.19 (95% CI 1.09–1.29; p = 0.001) in patients with elevated RDW levels.

Conclusion: Elevated RDW levels either at the time of admission, during the course of stay in hospital, or at the time of discharge significantly correlate with the increased all-cause mortality among CHF and CHD patients. Elevated RDW can have prognostic importance in anticipating the risk of death in these subset of patients.

Keywords: Red cell distribution width; congestive heart failure; coronary artery/heart disease; all-cause mortality.