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García-Escobar A, Lázaro-García R, Goicolea-Ruigómez J, González-Casal D, Fontenla-Cerezuela A, Soto N, González-Panizo J, Datino T, Pizarro G, Moreno R, Cabrera JÁ. Red Blood Cell Distribution Width is a Biomarker of Red Cell Dysfunction Associated with High Systemic Inflammation and a Prognostic Marker in Heart Failure and Cardiovascular Disease: A Potential Predictor of Atrial Fibrillation Recurrence. High Blood Press Cardiovasc Prev 2024:10.1007/s40292-024-00662-0. [PMID: 39031283 DOI: 10.1007/s40292-024-00662-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 07/12/2024] [Indexed: 07/22/2024] Open
Abstract
At the beginning of the 21st century, approximately 2.3 million US adults had atrial fibrillation (AF), and there has been a 60% increase in hospital admissions for AF. Given that the expectancy is a continuous increase in incidence, it portends a severe healthcare problem. Considerable evidence supports the immune system and inflammatory response in cardiac tissue, and circulatory processes are involved in the physiopathology of AF. In this regard, finding novel inflammatory biomarkers that predict AF recurrence after catheter ablation (CA) is a prime importance global healthcare problem. Many inflammatory biomarkers and natriuretic peptides came out and were shown to have predictive capabilities for AF recurrence in patients undergoing CA. In this regard, some studies have shown that red blood cell distribution width (RDW) is associated with the risk of incident AF. This review aimed to provide an update on the evidence of the RDW as a biomarker of red cell dysfunction and its association with high systemic inflammation, and with the risk of incident AF. Through the literature review, we will highlight the most relevant studies of the RDW related to AF recurrence after CA. Many studies demonstrated that RDW is associated with all cause-mortality, heart failure, cardiovascular disease, and AF, probably because RDW is a biomarker of red blood cell dysfunction associated with high systemic inflammation, reflecting an advanced heart disease with prognostic implications in heart failure and cardiovascular disease. Thus, suggesting that could be a potential predictor for AF recurrence after CA. Moreover, the RDW is a parameter included in routine full blood count, which is low-cost, quick, and easy to obtain. We provided an update on the evidence of the most relevant studies of the RDW related to AF recurrence after CA, as well as the mechanism of the high RDW and its association with high systemic inflammation and prognostic marker in cardiovascular disease and heart failure.
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Affiliation(s)
- Artemio García-Escobar
- Cardiology Department, Quirónsalud University Hospital Madrid, Calle Diego de Velázquez, 1, 28223, Pozuelo de Alarcón, Madrid, Spain.
- Cardiology Department, Ruber Juan Bravo Quirónsalud University Hospital, Calle de Juan Bravo, 49, 28006, Madrid, Spain.
| | - Rosa Lázaro-García
- Cardiology Department, Quirónsalud University Hospital Madrid, Calle Diego de Velázquez, 1, 28223, Pozuelo de Alarcón, Madrid, Spain
- Cardiology Department, Ruber Juan Bravo Quirónsalud University Hospital, Calle de Juan Bravo, 49, 28006, Madrid, Spain
| | - Javier Goicolea-Ruigómez
- Cardiology Department, Quirónsalud University Hospital Madrid, Calle Diego de Velázquez, 1, 28223, Pozuelo de Alarcón, Madrid, Spain
- Cardiology Department, Ruber Juan Bravo Quirónsalud University Hospital, Calle de Juan Bravo, 49, 28006, Madrid, Spain
| | - David González-Casal
- Cardiology Department, Quirónsalud University Hospital Madrid, Calle Diego de Velázquez, 1, 28223, Pozuelo de Alarcón, Madrid, Spain
- Cardiology Department, Ruber Juan Bravo Quirónsalud University Hospital, Calle de Juan Bravo, 49, 28006, Madrid, Spain
| | - Adolfo Fontenla-Cerezuela
- Cardiology Department, Quirónsalud University Hospital Madrid, Calle Diego de Velázquez, 1, 28223, Pozuelo de Alarcón, Madrid, Spain
- Cardiology Department, Ruber Juan Bravo Quirónsalud University Hospital, Calle de Juan Bravo, 49, 28006, Madrid, Spain
| | - Nina Soto
- Cardiology Department, Quirónsalud University Hospital Madrid, Calle Diego de Velázquez, 1, 28223, Pozuelo de Alarcón, Madrid, Spain
- Cardiology Department, Ruber Juan Bravo Quirónsalud University Hospital, Calle de Juan Bravo, 49, 28006, Madrid, Spain
| | - Jorge González-Panizo
- Cardiology Department, Quirónsalud University Hospital Madrid, Calle Diego de Velázquez, 1, 28223, Pozuelo de Alarcón, Madrid, Spain
- Cardiology Department, Ruber Juan Bravo Quirónsalud University Hospital, Calle de Juan Bravo, 49, 28006, Madrid, Spain
| | - Tomás Datino
- Cardiology Department, Quirónsalud University Hospital Madrid, Calle Diego de Velázquez, 1, 28223, Pozuelo de Alarcón, Madrid, Spain
- Cardiology Department, Ruber Juan Bravo Quirónsalud University Hospital, Calle de Juan Bravo, 49, 28006, Madrid, Spain
| | - Gonzalo Pizarro
- Cardiology Department, Quirónsalud University Hospital Madrid, Calle Diego de Velázquez, 1, 28223, Pozuelo de Alarcón, Madrid, Spain
- Cardiology Department, Ruber Juan Bravo Quirónsalud University Hospital, Calle de Juan Bravo, 49, 28006, Madrid, Spain
| | - Raúl Moreno
- Cardiology Department, La Paz University Hospital, Paseo de la Castellana, 261, 28046, Madrid, Spain
| | - José Ángel Cabrera
- Cardiology Department, Quirónsalud University Hospital Madrid, Calle Diego de Velázquez, 1, 28223, Pozuelo de Alarcón, Madrid, Spain
- Cardiology Department, Ruber Juan Bravo Quirónsalud University Hospital, Calle de Juan Bravo, 49, 28006, Madrid, Spain
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2
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Heshmat-Ghahdarijani K, Fakhrolmobasheri M. Is Red Cell Distribution Width a Reliable Marker for Cardiovascular Diseases? A Narrative Review. Cardiol Rev 2024; 32:362-370. [PMID: 36730493 DOI: 10.1097/crd.0000000000000500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Red cell distribution width (RDW) is an easy-to-access marker which is routinely measured in complete blood count (CBC) test. Besides the classic use of RDW as a marker for discriminating different types of anemia, recent studies had indicated the relationship between high RDW and cardiovascular diseases. High RDW is not only useful in the diagnosis and prognostication of various cardiovascular conditions but also could be used as a valuable tool for predicting the incidence of cardiovascular diseases. population-based studies have indicated that higher RDW could effectively predict the incidence of heart failure (HF), atherosclerotic diseases, and atrial fibrillation (AF). It has been also demonstrated that higher RDW is associated with worse outcomes in these diseases. Recent studies have shown that high RDW is also associated with other cardiovascular conditions including cardiomyopathies, and pulmonary hypertension. The predictive role of RDW in endovascular interventions has also been demonstrated by many recent studies. Here in this review, we attempt to compile the most recent findings with older reports regarding the relation between high RDW and HF, cardiomyopathies, pulmonary hypertension, AF, atherosclerotic disorders, primary hypertension, and the outcomes of endovascular interventions. we also discussed the role of RDW in the prognostication of different cardiovascular conditions when combined with classic classification criteria.
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Affiliation(s)
- Kiyan Heshmat-Ghahdarijani
- From the Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Fakhrolmobasheri
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Yoshimoto I, Inoue K, Oketani N, Ichiki H, Okada M, Tanaka N, Hirao Y, Oka T, Tanaka K, Harada S, Onishi T, Koyama Y, Okamura A, Iwakura K, Fujii K, Miyata M, Ohishi M. Decrease in red cell distribution width as a useful predictor of success after catheter ablation for atrial fibrillation: a retrospective multi-center study. Heart Vessels 2021; 37:99-109. [PMID: 34374825 DOI: 10.1007/s00380-021-01891-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 06/11/2021] [Indexed: 10/20/2022]
Abstract
Red cell distribution width (RDW) is reportedly associated with cardiovascular events, including atrial fibrillation (AF). We investigated whether the RDW values were associated with the outcomes of catheter ablation for AF. This retrospective multicenter study included 501 patients with AF (239 paroxysmal AF cases, 196 persistent AF cases, and 66 long-standing persistent AF cases) who underwent initial AF ablation between March 2017 and May 2018. The RDW values were evaluated before and at 1-3 months after the procedure. The patients were stratified based on the recurrence of AF within 1 year after the index procedure with a blanking period of 3 months into recurrence group (107 patients, 21.4%) and no-recurrence group (394 patients, 78.6%). There were no significant differences in preoperative RDW values between the groups (p = 0.37). The RDW value did not change significantly after the ablation in the recurrence group (13.55-13.60%, p = 0.37), although it decreased significantly in the no-recurrence group (13.64-13.37%, p < 0.001). Multivariate Cox proportional hazards regression analyses revealed that a postoperative change in RDW (ΔRDW) was independently associated with AF recurrence (hazard ratio 2.00, 95% confidence interval 1.42-2.76, p < 0.001). Receiver operating characteristic curve analysis revealed that a ΔRDW cut-off value of - 0.1% provided a c-statistic of 0.65 for predicting AF recurrence. Decrease in RDW during the blanking period after ablation independently predicted the 1-year success of AF ablation.
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Affiliation(s)
- Issei Yoshimoto
- Cardiovascular Center, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan.,Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Koichi Inoue
- Cardiovascular Center, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan. .,National Hospital Organization Osaka National Hospital, 2 Chome-1-14 Hoenzaka, Chuo Ward, Osaka, 540-0006, Japan.
| | - Naoya Oketani
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.,Kagosima City Hospital, Kagoshima, Japan
| | - Hitoshi Ichiki
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Masato Okada
- Cardiovascular Center, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan
| | - Nobuaki Tanaka
- Cardiovascular Center, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan
| | - Yuko Hirao
- Cardiovascular Center, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan
| | - Takafumi Oka
- Cardiovascular Center, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan
| | - Koji Tanaka
- Cardiovascular Center, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan
| | - Shinichi Harada
- Cardiovascular Center, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan
| | - Toshinari Onishi
- Cardiovascular Center, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan
| | - Yasushi Koyama
- Cardiovascular Center, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan
| | - Atsunori Okamura
- Cardiovascular Center, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan
| | - Katsuomi Iwakura
- Cardiovascular Center, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan
| | - Kenshi Fujii
- Cardiovascular Center, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan
| | - Masaaki Miyata
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.,Kagosima City Hospital, Kagoshima, Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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Wang Z, Korantzopoulos P, Roever L, Liu T. Red blood cell distribution width and atrial fibrillation. Biomark Med 2020; 14:1289-1298. [PMID: 33021384 DOI: 10.2217/bmm-2020-0041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Atrial fibrillation (AF) is the most frequent arrhythmia encountered in clinical practice and is a major health problem associated with remarkable morbidity, mortality and has considerable healthcare costs. Red blood cell distribution width (RDW) reflects the heterogeneity of the volume and size of red blood cells. It is an easily measured and inexpensive index that has been associated with several cardiovascular disease states. Accumulating evidence suggests that RDW is a prognostic marker of AF in various clinical settings. In this article, we review the available data regarding the prognostic role of RDW in AF development and perpetuation in diverse disease states as well as its role on the prediction of adverse outcomes.
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Affiliation(s)
- Zhaojia Wang
- Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, PR China
| | | | - Leonardo Roever
- Department of Clinical Research, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Tong Liu
- Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, PR China
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5
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Kim M, Hong M, Kim JY, Kim IS, Yu HT, Kim TH, Uhm JS, Joung B, Lee MH, Pak HN. Clinical relationship between anemia and atrial fibrillation recurrence after catheter ablation without genetic background. IJC HEART & VASCULATURE 2020; 27:100507. [PMID: 32258364 PMCID: PMC7125353 DOI: 10.1016/j.ijcha.2020.100507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 12/01/2022]
Abstract
Background Anemia is a known adverse prognostic factor among patients with cardiovascular diseases. We investigated whether the hemoglobin level was associated with the rhythm outcome after atrial fibrillation (AF) catheter ablation (AFCA). Methods We included 2627 patients who underwent AFCA and a guidelines-based rhythm follow-up (age 58 ± 10.9 years, 73% men, 30.6% with persistent AF), and evaluated the association of pre-AFCA anemia (haemoglobin <13 g/dL in men and <12 g/dL in women) and rhythm outcomes. We studied the mechanistic relationship between anemia and AF recurrence using a Mendelian randomization analysis (1775 subjects with genome-wide association study) after reviewing already proven 12 hemoglobin-associated genetic polymorphisms. Results The body mass index, paroxysmal AF, warfarin use, and baseline red cell distribution width were independently associated with anemia in patients with AF. During a 23-month follow-up (interval OR 9–48 months), the clinical AF recurrence rate was significantly higher in patients with than without anemia (log-rank p = 0.001; propensity score-matched log-rank p = 0.004). This pattern was more significant in male patients (Log-rank p < 0.001) or patients with paroxysmal AF (Log-rank p < 0.001). Anemia (hazard ratio [HR] 1.45 [1.17–1.80], p = 0.001), left atrial diameter (HR 1.03 [1.01–1.04], p < 0.001), a female sex (HR 1.17 [1.00–1.36], p = 0.047), and persistent AF (HR 1.58 [1.36–1.84], p < 0.001) were independently associated with post-AFCA clinical recurrence. In the Mendelian randomization, we could not find a significant direct causal relationship between anemia and AF recurrence at the genetic level. Conclusions Pre-AFCA anemia is an independent predictor of post-AFCA clinical recurrence, especially in male patients, without a genetically direct causal relationship.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Hui-Nam Pak
- Corresponding author at: 50 Yonseiro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
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6
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Lee KH, Cho JG, Park HW, Yoon NS, Jeong HK, Lee N. Role of Red Cell Distribution Width in the Relationship between Clinical Outcomes and Anticoagulation Response in Patients with Atrial Fibrillation. Chonnam Med J 2018; 54:113-120. [PMID: 29854676 PMCID: PMC5972124 DOI: 10.4068/cmj.2018.54.2.113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 03/30/2018] [Accepted: 04/03/2018] [Indexed: 02/03/2023] Open
Abstract
Little is known as to why elevated red cell distribution width (RDW) is associated with adverse clinical outcomes in patients with atrial fibrillation (AF). We hypothesized that RDW value might predict the intensity of anticoagulation, resulting in higher adverse events in patients with AF taking warfarin. We analyzed 657 patients with non-valuvular AF who took warfarin. The intensity of anticoagulation was assessed as mean time in the therapeutic range (TTR) and defined TTR ≥60% as an optimal intensity. The primary end-point was the composite of stroke/systemic embolism and major bleeding. The secondary end-point was the composite of stroke/systemic embolism, major bleeding and death. The relationship between the baseline RDW with TTR and clinical outcomes was assessed using categorical variables as quartiles or dichotomous variables. The mean value of TTR decreased as an increment of the RDW (45.2% vs. 44.7% vs. 40.8% vs. 35.2%, p<0.001). Primary and secondary end-points were significantly increased when TTR was less than 60% and RDW was more than 13.6%. Ratio of patients achieving optimal anticoagulation were significantly decreased as an increment of RDW. A RDW of ≥13.6% was a significant predictor for poor anticoagulation control (adjusted Odds ratio [OR] 0.43, 95% confidence interval [CI] 0.23–0.82), stroke (adjusted hazard ratio [HR] 3.86, 95% CI 1.11–13.40), primary (adjusted HR 1.88, 95% CI 1.12–3.16) and secondary end-point (adjusted HR 2.46, 95% CI 1.26–4.81). RDW was negatively associated with TTR in patients with AF. Therefore, RDW might be a useful marker for the prediction of anticoagulation response and clinical outcomes in patients with AF.
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Affiliation(s)
- Ki Hong Lee
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Jeong Gwan Cho
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Hyung Wook Park
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Nam Sik Yoon
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Hyung Ki Jeong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Nuri Lee
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
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7
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Shao Q, Korantzopoulos P, Letsas KP, Tse G, Hong J, Li G, Liu T. Red blood cell distribution width as a predictor of atrial fibrillation. J Clin Lab Anal 2018; 32:e22378. [PMID: 29315856 DOI: 10.1002/jcla.22378] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 12/12/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND 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. METHODS 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 I2 > 50% indicates at least moderate statistical heterogeneity. A sensitivity analysis and subgroup analysis were performed to find the origin of heterogeneity. RESULTS 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; I2 = 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 (I2 = 80.7%; P < .01). CONCLUSIONS Our comprehensive meta-analysis suggests that higher levels of RDW are associated with an increased risk of AF in different populations.
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Affiliation(s)
- Qingmiao Shao
- 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
| | | | - Konstantinos P Letsas
- Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, "Evangelismos" General Hospital of Athens, Athens, Greece
| | - Gary Tse
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, SAR, China.,Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Jiang Hong
- Department of Internal Medicine, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Guangping Li
- 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
| | - Tong Liu
- 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
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8
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Weymann A, Ali-Hasan-Al-Saegh S, Sabashnikov A, Popov AF, Mirhosseini SJ, Liu T, Lotfaliani M, Sá MPBDO, Baker WLL, Yavuz S, Zeriouh M, Jang JS, Dehghan H, Meng L, Testa L, D'Ascenzo F, Benedetto U, Tse G, Nombela-Franco L, Dohmen PM, Deshmukh AJ, Linde C, Biondi-Zoccai G, Stone GW, Calkins H, Surgery And Cardiology-Group Imcsc-Group IMAOC. Prediction of New-Onset and Recurrent Atrial Fibrillation by Complete Blood Count Tests: A Comprehensive Systematic Review with Meta-Analysis. Med Sci Monit Basic Res 2017; 23:179-222. [PMID: 28496093 PMCID: PMC5439535 DOI: 10.12659/msmbr.903320] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background Atrial fibrillation (AF) is one of the most critical and frequent arrhythmias precipitating morbidities and mortalities. The complete blood count (CBC) test is an important blood test in clinical practice and is routinely used in the workup of cardiovascular diseases. This systematic review with meta-analysis aimed to determine the strength of evidence for evaluating the association of hematological parameters in the CBC test with new-onset and recurrent AF. Material/Methods We conducted a meta-analysis of observational studies evaluating hematologic parameters in patients with new-onset AF and recurrent AF. A comprehensive subgroup analysis was performed to explore potential sources of heterogeneity. Results The literature search of all major databases retrieved 2150 studies. After screening, 70 studies were analyzed in the meta-analysis on new-onset AF and 23 studies on recurrent AF. Pooled analysis on new-onset AF showed platelet count (PC) (weighted mean difference (WMD)=WMD of −26.39×109/L and p<0.001), mean platelet volume (MPV) (WMD=0.42 FL and p<0.001), white blood cell (WBC) (WMD=−0.005×109/L and p=0.83), neutrophil to lymphocyte ratio (NLR) (WMD=0.89 and p<0.001), and red blood cell distribution width (RDW) (WMD=0.61% and p<0.001) as associated factors. Pooled analysis on recurrent AF revealed PC (WMD=−2.71×109/L and p=0.59), WBC (WMD=0.20×109/L (95% CI: 0.08 to 0.32; p=0.002), NLR (WMD=0.37 and p<0.001), and RDW (WMD=0.28% and p<0.001). Conclusions Hematological parameters have significant ability to predict occurrence and recurrence of AF. Therefore, emphasizing the potential predictive role of hematological parameters for new-onset and recurrent AF, we recommend adding the CBC test to the diagnostic modalities of AF in clinical practice.
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Affiliation(s)
- Alexander Weymann
- Department of Cardiac Surgery, University Hospital Oldenburg, European Medical School Oldenburg-Groningen, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Sadeq Ali-Hasan-Al-Saegh
- Afshar Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Anton Sabashnikov
- Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom.,Department of Thoracic and Cardiovascular Surgery, University Hospital Cologne, Cologne, Germany
| | - Aron-Frederik Popov
- Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom.,Department of Thoracic and Cardiovascular Surgery, University Hospital Goethe University Frankfurt, Frankfurt, Germany
| | - Seyed Jalil Mirhosseini
- Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Isfahan, Iran
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China (mainland)
| | - Mohammadreza Lotfaliani
- Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Isfahan, Iran
| | - Michel Pompeu Barros de Oliveira Sá
- Division of Cardiovascular Surgery, Pronto Socorro Cardiológico de Pernambuco - PROCAPE, Recife, Brazil.,University of Pernambuco - UPE, Recife, Brazil
| | - William L L Baker
- Department of Pharmacy, University of Connecticut/Hartford Hospital Evidence-Based Practice Center, Hartford, CT, USA
| | - Senol Yavuz
- Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Training and Research Hospital, Yıldırım/Bursa, Turkey
| | - Mohamed Zeriouh
- Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom.,Department of Thoracic and Cardiovascular Surgery, University Hospital Cologne, Cologne, Germany
| | - Jae-Sik Jang
- Department of Cardiology, Busan Paik Hospital, Inje University College of Medicine, Jin-gu, Korea, Democratic People's Republic of
| | - Hamidreza Dehghan
- Department of Health Technology Assessment, Shahid Sadoughi University of Medical Sciences and Health Services, Isfahan, Iran
| | - Lei Meng
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China (mainland)
| | - Luca Testa
- Department of Cardiology, IRCCS Pol. S. Donato, San Donato Milanese, Italy
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Umberto Benedetto
- Bristol Heart Institute, University of Bristol, School of Clinical Sciences, Bristol, United Kingdom
| | - Gary Tse
- Department of Medicine and Therapeutics, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Luis Nombela-Franco
- Instituto Cardiovascular, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Pascal M Dohmen
- Department of Cardiac Surgery, University Hospital Oldenburg, European Medical School Oldenburg-Groningen, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.,Department of Cardiothoracic Surgery, Faculty of Health Science, University of the Free State, Bloemfontein, South Africa
| | - Abhishek J Deshmukh
- Mayo Clinic Heart Rhythm Section, Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Cecilia Linde
- Department of Cardiology, Karolinska University Hospital, Karolinska Institut, Solna, Sweden
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy
| | - Gregg W Stone
- New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA
| | - Hugh Calkins
- Department of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
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Bassareo PP, Fanos V, Pala M, Antonucci L, Neroni P, Antonucci R, Mercuro G. Supraventricular tachycardia during the first year of life: is subclinical inflammation the trigger? J Matern Fetal Neonatal Med 2016; 31:53-58. [PMID: 28006998 DOI: 10.1080/14767058.2016.1275545] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Neutrophil/lymphocyte ratio (NLR) and red cell distribution width (RDW) may be associated with the onset of arrhythmias in adults, thus underlining a possible inflammatory etiology. Paroxysmal supraventricular tachycardia (SVT) is the most frequent pathological tachycardia in childhood. AIM To verify NLR and RDW levels in a group of children (<1 year) affected by SVT with a structurally normal heart and without fever or inflammatory diseases; to compare NLR and RDW before and after SVT resolution, to verify whether the latter was related with the reduction in inflammatory state; to identify - in SVT subtypes caused by a reentry mechanism - an NLR and RDW cutoff point beyond which adenosine was ineffective in preventing SVT recurrence. METHODS Eighteen SVT patients were recruited (mean age 18.9 ± 3.2 days; 50% males) and compared with 18 healthy peers. RESULTS NLR was higher in SVT group than in controls (p < 0.03). A significant difference was revealed between NLR values obtained on admission and at discharge (p < 0.05). On the contrary, no significant differences were found for RDW. It was not possible to identify NLR or RDW cutoffs capable of predicting SVT recurrence. However, all patients featuring SVT recurrence following adenosine injection presented with a lymphocyte count >6000/mm3. CONCLUSIONS Elevated NLR is associated with an increased risk of SVT during the first year of life, while its decline looks like to lead the SVT resolution. A subclinical inflammatory status, as assessed by lymphocytes count, influences SVT recurrence. These results provide further support for an inflammatory etiology of SVT in babies.
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Affiliation(s)
- Pier Paolo Bassareo
- a Department of Medical Sciences "M. Aresu" , University of Cagliari , Cagliari , Italy
| | - Vassilios Fanos
- b Department of Pediatrics and Clinical Medicine, Section of Neonatal Intensive Care Unit , University of Cagliari , Cagliari , Italy
| | - Mario Pala
- c Pediatric Cardiology Unit , AOU Sassari , Sassari , Italy
| | - Luca Antonucci
- a Department of Medical Sciences "M. Aresu" , University of Cagliari , Cagliari , Italy
| | - Paola Neroni
- b Department of Pediatrics and Clinical Medicine, Section of Neonatal Intensive Care Unit , University of Cagliari , Cagliari , Italy
| | | | - Guseppe Mercuro
- a Department of Medical Sciences "M. Aresu" , University of Cagliari , Cagliari , Italy
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Cystatin C and risk of atrial fibrillation in elderly hypertensive patients without chronic kidney disease. Int J Cardiol 2016; 212:262-4. [PMID: 27054500 DOI: 10.1016/j.ijcard.2016.03.076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 03/02/2016] [Accepted: 03/19/2016] [Indexed: 02/07/2023]
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