Shao Qingmiao, Korantzopoulos Panagiotis, Letsas Konstantinos P, Tse Gary, Hong Jiang, Li Guangping, Liu Tong
Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Tianjin, China.
First Department of Cardiology, University Hospital of Ioannina, Ioannina, Greece.
J Clin Lab Anal. 2018 Jun;32(5):e22378. doi: 10.1002/jcla.22378. Epub 2018 Jan 8.
Current evidence suggests that a higher red blood cell distribution width (RDW) may be associated with increased risk of atrial fibrillation (AF) 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 RDW and AF development.
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 RDW and AF development published until June 2016. We used both fix-effects and random-effects models to calculate the overall effect estimate. An I > 50% indicates at least moderate statistical heterogeneity. A sensitivity analysis and subgroup analysis were performed to find the origin of heterogeneity.
A total of 12 studies involving 2721 participants were included in this meta-analysis. The standardized mean difference in the RDW levels between patients with and those without AF development was 0.66 units (P < .05; 95% confidence interval 0.44-0.88). A significant heterogeneity between the individual studies was observed (P < .05; I = 80.4%). A significant association between the baseline RDW levels and AF occurrence or recurrence following cardiac procedure or surgery was evident (SMD: 0.61; 95% confidence interval 0.33-0.88; P < .05) with significant heterogeneity across the studies (I = 80.7%; P < .01).
Our comprehensive meta-analysis suggests that higher levels of RDW are associated with an increased risk of AF in different populations.
目前的证据表明，较高的红细胞分布宽度（RDW）可能与心房颤动（AF）发生风险增加相关。鉴于已发表了一些有争议的结果，我们对当前文献进行了系统综述并进行了全面的荟萃分析，以评估RDW与AF发生之间的关联。
我们使用电子数据库（PubMed、Ovid、Embase和Web of Science）对文献进行系统检索，以识别截至2016年6月发表的关于RDW与AF发生之间关联的研究。我们使用固定效应模型和随机效应模型来计算总体效应估计值。I²>50%表明至少存在中度统计学异质性。进行了敏感性分析和亚组分析以找出异质性的来源。
本荟萃分析共纳入12项研究，涉及2721名参与者。有AF发生和无AF发生患者之间RDW水平的标准化平均差异为0.66个单位（P<.05；95%置信区间0.44 - 0.88）。观察到各研究之间存在显著异质性（P<.05；I² = 80.4%）。基线RDW水平与心脏手术或外科手术后AF发生或复发之间存在显著关联（标准化平均差异：0.61；95%置信区间0.33 - 0.88；P<.05），各研究之间存在显著异质性（I² = 80.7%；P<.01）。
我们的全面荟萃分析表明，不同人群中较高水平的RDW与AF风险增加相关。
