Increased RDW And The Long-term Prognosis Of Patients With Acute Myocardial Infarction:A Systematic Review And Meta-analysis

Aims Recent years many studies have researched the long-term prognostic role of increased red blood cell distribution width(RDW) for acute myocardial infarction(AMI) patients, while the results have been inconsistent.The aim of the present study was to estimate the value of increased RDW on the prognosis of AMI by performing a systematic review and meta-analysis so as to provide an effective index to determine the long-term prognosis of patients with AMI.Methods The Pub Med,Embase,Cochrane library,and Web of Science databases were systematic retrieved up to July 21, 2015 to distinguish underlying eligible studies.The quality of all studies were evaluated by the Newcastle-Ottawa Scale(NOS). The relationship between RDW and AMI outcomes(all-cause mortality[ACM],cardiovascular death,rehospitalization,heart transplantation,etc.) were reviewed.The adjusted 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.Results Eleven studies, with a total of 14069 AMI patients, were included for systematic review.The HR for the effect of a 1% increase in baseline RDW on ACM was 1.12(95% CI: 1.05–1.20), based on pooling of two studies that provided related data. The HR for the effect of comparion higher RDW patients and lower RDW patients on ACM was 2.43(95% CI: 1.83–3.22), based on pooling of five studies that provided related data.But the results show that there was publication bias among these studies.Conclusions AMI patients with higher RDW may have poorer long-term prognosis than those with lower RDW. While some further studies are needed to confirm the conclusions and the potential association mechanisms between them.