توزیع سلول های قرمز خون به عنوان پیش بینی کننده فیبریلاسیون دهلیزی Red blood cell distribution width as a predictor of atrial fibrillation

1 | INTRODUCTION Atrial fibrillation (AF) is one of the commonest cardiac arrhythmias encountered in clinical practice, related to considerable cardiovascular morbidity and mortality. The association between inflammation and the development of AF is well recognized. Thus, different inflammatory biomarkers have been implicated in AF while anti-inflammatory upstream therapies may reduce AF burden. In this context, high sensitivity Creactive protein (hs-CRP) levels have been associated with a higher risk of AF recurrence after electrical cardioversion1,2 as well as after catheter ablation.3 Red blood cell distribution width (RDW) is a quantitative measure of variability of the size of circulating red blood cells. It can aid clinicians in the differential diagnosis of anemia.4 This is now routinely reported in complete blood count (CBC) tests and is readily available in hospital care settings. Elevated RDW has been observed in proinflammatory conditions.5,6 Of note, several studies have reported higher RDW levels as a strong independent predictor of morbidity and mortality in various cardiovascular disease states.7-14 Interestingly, several studies have reported on the association between RDW and the development of AF.15-17 Given that some controversial results have been published, we aimed to conduct a systematic review and meta-analysis to further elucidate the relationship between RDW and AF development. 2 | METHODS 2.1 | Search strategies and selection criteria PubMed, Ovid, Embase, and Web of Science were systematically and independently searched by two reviewers (Q. S. and T.L.) up to June 2016 to identify relevant articles evaluating the association between RDW and AF development. The search items were “red blood cell distribution width,” “RDW,” and “atrial fibrillation.” Additionally, a manual search was conducted in Abstract books of the scientific sessions of the American College of Cardiology (ACC), the American Heart Association (AHA), and the European Society of Cardiology (ESC) over the past 5 years. The inclusion criteria were as follows: (1) a prospective cohort study, retrospective cohort study, or case-control study; (2) RDW levels and clinical outcomes during follow-up were documented; (3) the potential association between RDW levels and AF development was examined; (4) diagnosis of AF was clearly defined in accordance with current guideline-based definitions. Published studies without language restriction were included.