Red blood cell distribution width: A marker of anisocytosis potentially associated with atrial fibrillation

Abstract

The incorporation of biomarkers in the actually used risk scores seem to be helpful for early identifying atrial fibrillation (AF) patients at higher risk. The aim of this critical review of the scientific literature is to investigate the potential clinical significance of red blood cell distribution width (RDW) in AF. A systematic electronic search was carried out to identify all articles describing an epidemiological association between RDW and AF in adult human populations. Data abstraction was conducted on a final number of 35 articles (13 cross-sectional, 12 prospective and 10 retrospective studies). The results of these epidemiological investigations were all virtually concordant to emphasize that an enhanced RDW value is not only a predictive factor and a marker of AF but its measurement may also be helpful for predicting the risk of developing many adverse complications in patients with AF, such as recurrence and duration of AF, hospitalization for heart failure, bleeding, left atrial thrombosis and stasis, thromboembolic events and mortality. AF patients with RDW values exceeding the local reference range may be more aggressively investigated and managed, in order to identify and attenuate the impact of possible underlying disorders causing both anisocytosis and AF.

Early Mortality of Brain Infarction Patients and Red Blood Cell Distribution Width

“…Different factors have been associated with the outcome stroke such as oxidation [17,18], inflammation [19][20][21][22], hyperglycemia [23], or alterations in brain perfusion due to blood pressure variability [24,25]. In addition, there has been found the association of RDW with oxidative stress in animal models [26], with blood TNF-alpha levels in critically ill patients [27,28], and with atrial fibrillation and its risk of complications and mortality [29][30][31]. Another novel finding of our study was that there is a positive association between RDW and blood levels of malondialdehyde and TNF-alpha during the first week of MMCAI.…”

Red Cell Distribution Width and Risk of Atrial Fibrillation and Subsequent Thromboembolism: The Tromsø Study

“…An association between reduced erythrocyte deformability and cardiac arrhythmias has been demonstrated previously. 39 As addressed by a recent review, 40 anemia is associated with both AF development and increased RDW. 40 In the present study, risk estimates for AF were not significantly modified by adjusting for hemoglobin levels in the regression models, nor by excluding anemic participants from the multivariable analyses.…”

“…39 As addressed by a recent review, 40 anemia is associated with both AF development and increased RDW. 40 In the present study, risk estimates for AF were not significantly modified by adjusting for hemoglobin levels in the regression models, nor by excluding anemic participants from the multivariable analyses. Previous observational studies, including reports from the Tromsø Study, have reported an increased risk of both VTE 13,14 and ischemic stroke 11,12 by RDW in the general population.…”

Association between routine biomarkers and atrial fibrillation in patients undergoing implantation of a dual‐chamber pacemaker

“…13,[15][16][17][18][19][20][21][22] RDW is a marker of anisocytosis of erythrocytes and is related to inflammatory and oxidative stress. 13,17 Interestingly, a relation of RDW with inflammatory and oxidative markers in an experimental model of atrial tachy-pacing has been demonstrated. 18 We have also previously published data indicating an association between baseline RDW levels and postoperative AF after cardiac operations.…”

“…19 Of note, recent systematic reviews and meta-analyses indicate that RDW is an independent predictor of AF in several clinical settings as well as a predictor of adverse outcomes and complications in AF patients. 13,17 On the other hand, increased activity of γGT is associated with increased oxidative stress and increased cardiovascular risk and mortality. 20 An increasing body of evidence indicates a significant association between increased γGT levels, within normal limits, and AF.…”