Impact of pre-procedural red cell distribution width on one-year all-cause mortality following transcatheter aortic valve replacement: A systematic review and meta-analysis.

Background: Red cell distribution width (RDW) has emerged as a novel biomarker associated with adverse outcomes in patients with cardiovascular disease (CVD). We aimed to determine the prognostic significance of pre-procedural RDW levels on one-year all-cause mortality (ACM) following transcatheter aortic valve replacement (TAVR) by conducting a systematic review and meta-analysis due to limited evidence on the impact of RDW levels in TAVR patients.

Methods: We systematically reviewed articles on pre-procedural RDW and one-year ACM post-TAVR until February 2024 using PubMed and Google Scholar. Binary random effects model was used for pooled adjusted odds ratio (aOR), with 95 % confidence intervals (CI) and I2 statistics for heterogeneity.

Results: A total of 7 studies with 3273 patients aged between 70-90 years and 45 % males were analyzed. High pre-procedural RDW was an independent predictor of one-year ACM (aOR 1.60, 95%CI 1.13-2.27, p < 0.01). This association is even more prominent when aged > 80 years vs. <80 years (aOR 1.64, 95 % CI 1.17-2.31, p < 0.01 vs. aOR 1.46, 95 % CI 0.49-4.32, p < 0.01). Leave-one-out sensitivity analysis validated the robustness of our meta-analysis.

Conclusions: Our study indicated that elevated baseline RDW is an independent predictor of one-year ACM post-TAVR. Further studies are needed to validate the importance of RDW as a marker of post-TAVR outcomes.