title: An overall and dose-response meta-analysis of red blood cell distribution width and CVD outcomes.
abstract: Red blood cell distribution width (RDW) is the coefficient of variation of red blood cell size, considered to be associated with cardiovascular disease (CVD). This study aimed to comprehensively synthesize previous studies on RDW and CVD outcomes through an overall and dose-response meta-analysis. PubMed, Embase and Web of Science were searched systematically for English and Chinese language publications up to November 30, 2015. We extracted data from publications matching our inclusion criteria for calculating pooled hazard ratio (HR), which was used to assess prognostic impact of RDW on CVD. Twenty-seven articles, consisting of 28 studies and 102,689 participants (mean age 63.9 years, 63,703 males/36,846 females, 2,140 gender-unmentioned subjects) were included in the present meta-analysis. The pooled HRs are 1.12 (95% CI = 1.09-1.15) for the association of all-cause mortality (ACM) per 1% increase of RDW, 1.12(95% CI = 1.08-1.17) for major adverse cardiac events (MACEs) per 1% increase of RDW. A dose-response curve relating RDW increase to its effect on CVD outcomes was established (pcurve< 0.001). For every 1-unit increase of RDW, there is an increased risk of occurrence of ACM (pooled HR = 1.03, 95% CI = 1.02-1.04) and MACEs (pooled HR = 1.04, 95% CI = 1.01-1.06). This study indicates RDW may be a prognostic indicator for CVD outcomes.
authors.affiliation: School of Public Health, Taishan Medical University, Taian, 271000, China.|School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.
authors.forename: Haifeng
authors.initials: H
authors.lastname: Hou
authors.affiliation: School of Public Health, Taishan Medical University, Taian, 271000, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Sun
authors.affiliation: Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, 200025, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Li
authors.affiliation: Affiliated Hospital, Taishan Medical University, Taian, 271000, China.
authors.forename: Yuanmin
authors.initials: Y
authors.lastname: Li
authors.affiliation: School of Public Health, Taishan Medical University, Taian, 271000, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Guo
authors.affiliation: School of Public Health, Taishan Medical University, Taian, 271000, China.|School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: School of Public Health, Taishan Medical University, Taian, 271000, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Li
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000032:analysis; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis*; D004909:Erythrocyte Indices; D004912:Erythrocytes / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models
chemical_list: D015415:Biomarkers