THE ROLE OF THE RED CELL DISTRIBUTION WIDTH IN CAROTID ARTERY DISEASE
Introduction: Carotid disease affects 3-4% of the general population. The association between systemic low-grade inflammation and atherosclerosis has led to the study of blood biomarkers, such as red blood cell distribution width – coefficient of variation (RDW-CV), and their role in the pathophysiology and prognosis of carotid artery disease. The aim of this study was to review the literature regarding the relevance of RDW-CV in carotid artery disease.
Methods: A Medline search was performed in order to identify publications focused on the physiopathology of RDW-CV and its impact in patients with carotid artery disease.
Results: Increased RDW-CV was associated with increased carotid intima-media thickness (CIMT) in several studies. It was associated with plaque presence and progression. One study demonstrated an independent association between all-cause and cardiovascular-related mortality in patients with asymptomatic carotid artery stenosis and increased RDW-CV.
Conclusion: RDW-CV is a widely available, easy to measure, and low-cost marker that seems to be associated with subclinical carotid atherosclerosis. However, further studies are needed in order to determine its clinical relevance in this setting.
2. Bejot Y, Bailly H, Durier J, Giroud M. Epidemiology of stroke in Europe and trends for the 21st century. Presse Med. 2016;45(12 Pt 2):e391-e8.
3. Naylor AR, Ricco JB, de Borst GJ, Debus S, de Haro J, Halliday A, et al. Editor's Choice - Management of Atherosclerotic Carotid and Vertebral Artery Disease: 2017 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2018;55(1):3-81.
4. Willeit P, Thompson SG, Agewall S, Bergstrom G, Bickel H, Catapano AL, et al. Inflammatory markers and extent and progression of early atherosclerosis: Meta-analysis of individual-participant-data from 20 prospective studies of the PROG-IMT collaboration. Eur J Prev Cardiol. 2016;23(2):194-205.
5. Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2015;52(2):86-105.
6. Uchida T. Change in red blood cell distribution width with iron deficiency. Clin Lab Haematol. 1989;11(2):117-21.
7. Patel HH, Patel HR, Higgins JM. Modulation of red blood cell population dynamics is a fundamental homeostatic response to disease. Am J Hematol. 2015;90(5):422-8.
8. Tonelli M, Wiebe N, James MT, Naugler C, Manns BJ, Klarenbach SW, et al. Red cell distribution width associations with clinical outcomes: A population-based cohort study. PLoS One. 2019;14(3):e0212374.
9. Poludasu S, Marmur JD, Weedon J, Khan W, Cavusoglu E. Red cell distribution width (RDW) as a predictor of long-term mortality in patients undergoing percutaneous coronary intervention. Thromb Haemost. 2009;102(3):581-7.
10. Ye WY, Li J, Li X, Yang XZ, Weng YY, Xiang WW, et al. Predicting the One-Year Prognosis and Mortality of Patients with Acute Ischemic Stroke Using Red Blood Cell Distribution Width Before Intravenous Thrombolysis. Clin Interv Aging. 2020;15:255-63.
11. Wonnerth A, Krychtiuk KA, Mayer FJ, Minar E, Wojta J, Schillinger M, et al. Red cell distribution width and mortality in carotid atherosclerosis. Eur J Clin Invest. 2016;46(2):198-204.
12. Soderholm M, Borne Y, Hedblad B, Persson M, Engstrom G. Red cell distribution width in relation to incidence of stroke and carotid atherosclerosis: a population-based cohort study. PLoS One.
13. Ren D, Wang J, Li H, Li Y, Li Z. Red blood cell distribution width and carotid intima-media thickness in patients with metabolic syndrome. BMC Cardiovasc Disord. 2017;17(1):44.
14. Nam JS, Ahn CW, Kang S, Kim KR, Park JS. Red Blood Cell Distribution Width Is Associated with Carotid Atherosclerosis in People with Type 2 Diabetes. J Diabetes Res. 2018;2018:1792760.
15. Furer A, Finkelstein A, Halkin A, Revivo M, Zuzut M, Berliner S, et al. High red blood cell distribution width and preclinical carotid atherosclerosis. Biomarkers. 2015;20(6-7):376-81.
16. Lappegard J, Ellingsen TS, Vik A, Skjelbakken T, Brox J, Mathiesen EB, et al. Red cell distribution width and carotid atherosclerosis progression. The Tromso Study. Thromb Haemost. 2015;113(3):649-54.
17. Wen Y. High red blood cell distribution width is closely associated with risk of carotid artery atherosclerosis in patients with hypertension. Exp Clin Cardiol. 2010;15(3):37-40.
18. Bojakowski K, Religa P, Andziak P, Gaciong Z. Red-cell distribution width is associated with higher risk of vascular complications after carotid thromboendartherectomy. Pol Merkur Lekarski.
19. Pilling LC, Atkins JL, Kuchel GA, Ferrucci L, Melzer D. Red cell distribution width and common disease onsets in 240,477 healthy volunteers followed for up to 9 years. PLoS One. 2018;13(9):e0203504.
20. Gurbuz O, Kumtepe G, Ozkan H, Karal IH, Ercan A, Ener S. Red blood cell distribution width predicts long term cardiovascular event after on-pump beating coronary artery bypass grafting. J Cardiothorac Surg. 2016;11:48.
21. Xanthopoulos A, Giamouzis G, Melidonis A, Kitai T, Paraskevopoulou E, Paraskevopoulou P, et al. Red blood cell distribution width as a prognostic marker in patients with heart failure and diabetes mellitus. Cardiovasc Diabetol. 2017;16(1):81.
22. Bujak K, Wasilewski J, Osadnik T, Jonczyk S, Kolodziejska A, Gierlotka M, et al. The Prognostic Role of Red Blood Cell Distribution Width in Coronary Artery Disease: A Review of the Pathophysiology. Dis Markers. 2015;2015:824624.
23. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009;133(4):628-32.