Table 7.
Studies exploring association between red blood cell distribution width (RDW) and carotid atherosclerosis and stroke.
| First author, journal, year | Study design | Study population | Mean follow-up | Major outcomes | Major limitations |
|---|---|---|---|---|---|
| (i) Wen et al. [67]
(ii) Experimental and Clinical Cardiology (iii) 2010 |
Cross-sectional study | 156 hypertensive inpatients, age 60–85 years | — | A high baseline RDW was observed in patients with an increased IMT/ID ratio (95% CI: 4.54–28.59; p = 0.008)
IMT means intimal-medialthickness ID means inner diameter |
The sample size was relatively small |
| (i) Kaya et al. [138]
(ii) Clinical and Applied Thrombosis/hemostasis (iii) 2013 |
Prospective study | 153 patients with heart failure, age 56–76 years | 1 year | An RDW ≥ 15.2% measured on admission had 87% sensitivity and 74% specificity in predicting stroke in patients with heart failure (area under the curve: 0.923, 95% CI: 0.852–0.994, p < 0.001) | (i) The sample size was relatively small
(ii) Not make distinction between hemorrhagic and ischemic stroke (iii) The RDW may increase in many clinical situations, only the Hb level was checked in this study |
| (i) Wonnerth et al. [139]
(ii) European Journal of Clinical Investigation (iii) 2014 |
Prospective, single-center, cross-sectional cohort | 1286 patients with neurological asymptomatic carotid atherosclerosis | A median of 6.2 years | HR (1-SD increment of RDW) was 1.39 (95% CI: 1.27–1.53; p < 0.001) for all cause and 1.43 (95% CI: 1.28–160; p < 0.001) for cardiovascular mortality, respectively | (i) Data deriving from a post-hoc analysis of a prospective single-centerinvestigation, possible explanations for RDW variations cannot be addressed
(ii) Not illustrate the accurate mechanism |
| (i) Vijayashree et al. [140]
(ii) Archives of Medical Science Ams (iii) 2014 |
Retrospective cross-sectional study | 236 patients hospitalized at the neurology ward, age 18–55 years | — | The mean RDW values of young patients with stroke were significantly higher than patients with epilepsy or multiple sclerosis (14.9 ± 1.2, 13.3 ± 1.2, 13.4 ± 0.6, p < 0.0001, resp.) | (i) The study was carried out in only one center
(ii) Not illustrate the accurate mechanism |
| (i) Söderholm et al. [68]
(ii) Plos One (iii) 2015 |
Population-based cohort study | 26,879 participants without history of coronary events or stroke | A mean of 15.2 years | (i) Incidences of total cerebral infarction (n = 1,544) and stroke (n = 1,869) were both increased in individuals with high RDW
(ii) RDW was positively associated with intima-media thickness of the common carotid artery (p = 0.011) |
(i) The numbers of intracerebral hemorrhage and subarachnoid hemorrhage cases were considerably lower
(ii) Not illustrate the accurate mechanism |
| (i) Güçlü et al. [141]
(ii) Turkish Nephrology Dialysis and Transplantation Journal (iii) 2016 |
Post hoc analysis | (i) 30 healthy controls, age 52.76 ± 13.57 years
(ii) 30 patients with chronic kidney disease, age 52.28 ± 13.75 years (iii) 37 hemodialysis patients, age 56.02 ± 16.06 |
— | The RDW value was higher in the predialysis group than controls with a trend to statistical significance (p = 0.067). RDW value showed positive correlation with intima-media thickness (r : 0.356p = 0.012) and CRP (r : 0.361p = 0.004) | (i) The sample size was relatively small
(ii) Not illustrate the accurate mechanism |
| (i) Lappegård et al. [142]
(ii) Thrombosis and Haemostasis (iii) 2016 |
A single-center prospective, population-based study | 25,992 participants, age > 25 years | A mean of 15.8 years | HR for higher risk of stroke (1-SD increment of RDW): 1.13 (95% CI, 1.07–1.20) | (i) There was only one measurement of RDW throughout the study period
(ii) Residual confounding cannot be completely ruled out |
| (i) Ren et al. [143]
(ii) BMC Cardiovascular Disorders (iii) 2017 |
Cross-sectional study | 803 patients with metabolic syndrome undergoing carotid ultrasonography examination, age 24 to 54 years | — | Compared with the first quartile, people with third and fourth quartile level gave obvious higher risk of carotid artery atherosclerotic trend (OR = 1.41, 95% CI: 1.01–197; OR = 2.10, 95% CI: 1.30–3.40) | (i) The cross-sectional design limits the causal relationship between RDW and carotid intimal-medial thickness
(ii) Only metabolic syndrome patients were included (iii) Not include drug history in the final analysis (iv) Not illustrate the accurate mechanism |