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红细胞分布宽度对行经皮冠状动脉介入治疗患者的预后价值:一项荟萃分析。

Prognostic value of red cell distribution width in patients undergoing percutaneous coronary intervention: a meta-analysis.

机构信息

Department of Cardiovascular disease, Yiwu Central Hospital, Yiwu, China

Department of Cardiovascular disease, Yiwu Central Hospital, Yiwu, China.

出版信息

BMJ Open. 2020 Sep 10;10(9):e033378. doi: 10.1136/bmjopen-2019-033378.

Abstract

OBJECTIVE

To evaluate the prognostic value of baseline red cell distribution width (RDW) in patients with coronary artery diseases (CADs) undergoing percutaneous coronary intervention (PCI) by conducting a meta-analysis.

DESIGN

Systematic review and meta-analysis.

DATA SOURCE

PubMed, Embase, Wanfang, CNKI and VIP databases were searched from their inceptions to 19 June 2019.

ELIGIBLE CRITERIA

Studies investigating the value of baseline RDW for predicting all-cause mortality, cardiovascular mortality and major adverse cardiac events (MACEs) in patients with CAD undergoing PCI were included.

DATA EXTRACTION AND SYNTHESIS

Two authors independently extracted the data and evaluated the methodological quality using the Newcastle-Ottawa Scale. STATA V.12.0 software was applied to produce the forest plots using a random-effect model.

RESULTS

Twelve studies (13 articles) involving 17 113 patients were included and analysed. Comparison between the highest and lowest RDW category indicated that the pooled risk ratio (RR) was 1.77 (95% CI 1.32 to 2.37) for all-cause mortality, 1.70 (95% CI 1.25 to 2.32) for cardiovascular mortality and 1.62 (95% CI 1.21 to 2.18) for MACEs. The predictive effect of elevated RDW for all-cause mortality was stronger in the subgroup of patients without anaemia (RR 4.59; 95% CI 3.07 to 6.86) than with anaemia.

CONCLUSIONS

This meta-analysis indicated that elevated RDW was associated with higher risk of mortality and adverse cardiac events in patients with CAD undergoing PCI. The value of elevated RDW for predicting all-cause mortality appears to be stronger in patients without anaemia. RDW may be served as a promising prognostic biomarker in patients undergoing PCI.

摘要

目的

通过荟萃分析评估基线红细胞分布宽度(RDW)在接受经皮冠状动脉介入治疗(PCI)的冠状动脉疾病(CAD)患者中的预后价值。

设计

系统评价和荟萃分析。

资料来源

从建库至 2019 年 6 月 19 日,检索 PubMed、Embase、万方、中国知网和 VIP 数据库。

入选标准

纳入研究基线 RDW 预测 CAD 患者 PCI 后全因死亡率、心血管死亡率和主要不良心脏事件(MACEs)的价值。

资料提取和合成

两名作者独立提取数据,并使用纽卡斯尔-渥太华量表评估方法学质量。使用 STATA V.12.0 软件采用随机效应模型生成森林图。

结果

纳入 12 项研究(13 篇文章)共 17113 例患者进行分析。最高和最低 RDW 组间比较显示,全因死亡率的汇总风险比(RR)为 1.77(95%CI 1.32 至 2.37),心血管死亡率为 1.70(95%CI 1.25 至 2.32),MACEs 为 1.62(95%CI 1.21 至 2.18)。在无贫血患者亚组中,升高的 RDW 对全因死亡率的预测作用强于贫血患者(RR 4.59;95%CI 3.07 至 6.86)。

结论

本荟萃分析表明,升高的 RDW 与 CAD 接受 PCI 治疗的患者死亡率和不良心脏事件风险增加相关。在无贫血患者中,升高的 RDW 预测全因死亡率的价值似乎更强。RDW 可能是 PCI 患者有前途的预后生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8750/7485231/2ed118ec5f3a/bmjopen-2019-033378f01.jpg

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