Abstract
AimsMultiple studies have investigated the prognostic role of red blood cell distribution width (RDW) for patients with heart failure (HF), but the results have been inconsistent. The aim of the present study was to estimate the impact of RDW on the prognosis of HF by performing a systematic review and meta-analysis.Methods and ResultsThe Embase, PubMed, and Web of Science databases were searched up to November 16, 2013 to identify eligible cohort studies. The quality of each study was assessed using the Newcastle-Ottawa Scale (NOS). The association between RDW, either on admission or at discharge, and HF outcomes (all-cause mortality [ACM], heart transplantation, cardiovascular mortality, and rehospitalization, etc.) were reviewed. The overall hazard ratio (HR) for the effect of RDW on ACM was pooled using a random-effects model, and the publication bias was evaluated using funnel plots and Eggers' tests. Seventeen studies, with a total of 18288 HF patients, were included for systematic review. All eligible studies indicated that RDW on admission and RDW at discharge, as well as its change during treatment, were of prognostic significance for HF patients. The HR for the effect of a 1% increase in baseline RDW on ACM was 1.10 (95% confidence interval: 1.07–1.13), based on pooling of nine studies that provided related data. However, publication bias was observed among these studies.ConclusionsHF patients with higher RDW may have poorer prognosis than those with lower RDW. Further studies are needed to explore the potential mechanisms underlying this association.
Highlights
Heart failure (HF) has been recognized as one of the most severe cardiovascular syndromes worldwide, with a high incidence, prevalence, mortality and morbidity [1]
The present systematic review and meta-analysis indicated that increased Red blood cell distribution width (RDW), either at baseline or at discharge, as well as the change in RDW during treatment are associated with poor prognosis in patients with HF
The meta-analysis of the results of nine studies demonstrated that the pooled hazard ratio (HR) for a 1% increase in RDW for ACM was 1.10, suggesting that the risk of ACM increases by 10% with each 1% increase in the baseline RDW
Summary
Heart failure (HF) has been recognized as one of the most severe cardiovascular syndromes worldwide, with a high incidence, prevalence, mortality and morbidity [1]. Laboratory tests, imaging examinations, and clinical signs are three categories of tools widely used in HF prognosis estimation [4,5]. The clinical significance of RDW in non-hematologic disorders, such as liver diseases [10,11], autoimmune diseases [12,13], respiratory diseases [14,15], stroke [16,17], critical illness [18,19], and cardiovascular diseases [20], has been extensively investigated. Many studies have explored the prognostic value of RDW for HF, but the results have been inconsistent.
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