Red Blood Cell Distribution Width as Novel Biomarker in Cardiovascular Diseases: A Literature Review

Abstract

Red blood cell distribution width (RDW) is a measure of the change in size of red blood cells and it is used in combination with other hematological parameters for the differential diagnosis of anemias. Recent evidence suggested that the change in RDW level may be a predictive biomarker of morbidity and mortality in cardiovascular diseases (CVDs). Cardiovascular diseases are the most common cause of death globally as compared to cancer and communicable diseases. Early diagnosis and prompt intervention of these diseases are very important to minimize their complications. Nowadays, the diagnosis of most cardiovascular diseases majorly depends on clinical judgment, electrocardiography and biochemical parameters. Red blood cell distribution width as a new predictive biomarker may play a pivotal role in assessing the severity and progression of CVDs. However, the underlying mechanisms for the association between RDW and CVDs are not clear. A deeper understanding of their association could help the physicians in more careful identification, early prevention, intervention, and treatment to prevent adverse cardiovascular events. This review aims to elaborate on the recent knowledge on the association between RDW and cardiovascular diseases and some possible pathophysiological mechanisms.

Keywords:

• biomarkers
• cardiovascular diseases
• inflammation
• red blood cell distribution width
• prognosis

Abbreviations

ACS, acute coronary syndrome; AF, atrial fibrillation; AMI, acute myocardial infarction; AUC, area under the curve; CAD, coronary artery disease; CBC, complete blood cell count; CEM, cholesterol content of erythrocyte membranes; CI, confidence interval; CVDs, cardiovascular diseases; EPO, erythropoietin; HCY, homocysteine; HF, heart failure; HR, hazard ratio; hsCRP, highly sensitive C-reactive protein; IL-1β, interleukin 1 beta; IL-6, interleukin 6; MCV, mean corpuscular volume; MPs, microparticles; NO, nitric oxide; NT-proBNP; N-terminal pro-B-type natriuretic peptide; OR, odds ratio; PAD, peripheral artery disease; RBC, red blood cell; RDW, red blood cell distribution width; ROC, receiver operating characteristic; SD, standard deviation; TNF-α, tumor necrosis factor-alpha.

Compliance with Ethics Guideline

This review is based on previously conducted studies and does not contain any studies with human participants or animals performed by any of the authors.

Disclosure

The authors declare no conflicts of interest in relation to this work.

Additional information

Funding

No funding was received for this study or publication of this article.