Systematic literature review and critical analysis of RDW in patients with aortic pathologies

Diseases of the aorta, such as aortic aneurysm, dissection, and rupture, account for a large proportion of acute clinical emergencies. The red blood cell distribution width (RDW), which directly reflects anisocytosis (i.e., the heterogeneity of erythrocyte volumes), has emerged as a promising biomarker for many cardiovascular pathologies. Thus, we aimed to explore the implication of RDW in aortic pathologies. We searched Scopus and PubMed using the keywords "RDW" OR "red blood cell distribution width" AND "aortic aneurysm" OR "aortic dilatation" OR "aortic dissection" for identifying studies in which RDW values were measured in patients with these aortic diseases. Ten observational studies were finally included. In all studies, RDW value was increased in patients with aortic diseases. In the four studies in which sufficient RDW data were available for pooling, the weighted mean difference (WMD) of RDW in patients with or without complicated aortic pathologies was 0.575 (95%CI, 0.254-0.896). RDW may be a valuable diagnostic and prognostic biomarker in patients with aortic pathologies.