Red blood cell distribution width as a predictor of atrial fibrillation

Abstract

<div class="section"> <a class="named-anchor" id="jcla22378-sec-0001"> <!-- named anchor --> </a> <h5 class="section-title" id="d1193981e341">Background</h5> <p id="d1193981e343">Current evidence suggests that a higher red blood cell distribution width ( <span style="fixed-case">RDW</span>) may be associated with increased risk of atrial fibrillation ( <span style="fixed-case">AF</span>) development. Given that some controversial results have been published, we conducted a systematic review of the current literature along with a comprehensive meta‐analysis to evaluate the association between <span style="fixed-case">RDW</span> and <span style="fixed-case">AF</span> development. </p> </div><div class="section"> <a class="named-anchor" id="jcla22378-sec-0002"> <!-- named anchor --> </a> <h5 class="section-title" id="d1193981e358">Methods</h5> <p id="d1193981e360">We performed a systematic search of the literature using electronic databases (PubMed, Ovid, Embase, and Web of Science) to identify studies reporting on the association between <span style="fixed-case">RDW</span> and <span style="fixed-case">AF</span> development published until June 2016. We used both fix‐effects and random‐effects models to calculate the overall effect estimate. An <i>I</i> ² &gt; 50% indicates at least moderate statistical heterogeneity. A sensitivity analysis and subgroup analysis were performed to find the origin of heterogeneity. </p> </div><div class="section"> <a class="named-anchor" id="jcla22378-sec-0003"> <!-- named anchor --> </a> <h5 class="section-title" id="d1193981e375">Results</h5> <p id="d1193981e377">A total of 12 studies involving 2721 participants were included in this meta‐analysis. The standardized mean difference in the <span style="fixed-case">RDW</span> levels between patients with and those without <span style="fixed-case">AF</span> development was 0.66 units ( <i>P</i> &lt; .05; 95% confidence interval 0.44‐0.88). A significant heterogeneity between the individual studies was observed ( <i>P</i> &lt; .05; <i>I</i> ² = 80.4%). A significant association between the baseline <span style="fixed-case">RDW</span> levels and <span style="fixed-case">AF</span> occurrence or recurrence following cardiac procedure or surgery was evident ( <span style="fixed-case">SMD</span>: 0.61; 95% confidence interval 0.33‐0.88; <i>P</i> &lt; .05) with significant heterogeneity across the studies ( <i>I</i> ² = 80.7%; <i>P</i> &lt; .01). </p> </div><div class="section"> <a class="named-anchor" id="jcla22378-sec-0004"> <!-- named anchor --> </a> <h5 class="section-title" id="d1193981e421">Conclusions</h5> <p id="d1193981e423">Our comprehensive meta‐analysis suggests that higher levels of <span style="fixed-case">RDW</span> are associated with an increased risk of <span style="fixed-case">AF</span> in different populations. </p> </div>