A-45 | Red blood cell distribution width as a long-term prognostic marker in patients with coronary artery disease undergoing percutaneous coronary intervention: An updated meta-analysis

Red cell distribution width (RDW), a routine blood indicator, assesses mortality risk in coronary artery disease (CAD). Considering varied consensus, we explored RDW's predictive value in long-term mortality risk in patients with CAD post percutaneous coronary intervention (PCI). PubMed/Medline, Google Scholar, and SCOPUS databases were systematically reviewed for studies (Jan 2019 to Jan 2024) examining RDW's association with long-term follow-up, all-cause, and cardiovascular mortality in CAD patients undergoing PCI. Primary outcomes include cardiovascular and all-cause mortality (ACM). Pooled outcomes used binary random effects models with I2 statistics for inter-study heterogeneity. Leave-one-out meta-analysis assessed individual study impact on overall estimate, and statistical significance was set at p<0.05. Our meta-analysis of five studies (3 China, 1 Brazil, 1 Taiwan) included 17,583 CAD patients post-PCI, mostly males (76.6%, n=13,469). Median follow-up was 2.78 years. Pooled analysis revealed that RDW independently predicted all-cause mortality (OR 1.65, 95CI 1.20-2.28, p<0.01, I2=79.86%), with no significance in cardiovascular mortality (OR 1.39, 95CI 1.18-1.63, p=0.2, I2=37.89%). Adjusted for modifiable risk factors, multivariate odds revealed a strong association with ACM (OR 2.1, 95CI 1.54-2.87, p<0.01, I2=77.41%). Leave-one-out sensitivity analysis confirmed robustness of findings. This meta-analysis showed RDW as an independent predictor for long-term all-cause mortality in CAD patients post-PCI, suggesting clinical utility for outcome improvement.