Senapati SG, Kothawala A, Ahluwalia V, Desai R. High red cell distribution width as a prognostic indicator in heart failure. World J Methodol 2026; 16(1): 108611 [DOI: 10.5662/wjm.v16.i1.108611]
Corresponding Author of This Article
Sidhartha Gautam Senapati, MD, Department of Internal Medicine, Texas Tech University Health Sciences Center El Paso, 5001 El Paso Drive, El Paso, TX 79905, United States. senapati.sidhartha36@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Meta-Analysis
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mar 20, 2026 (publication date) through Feb 10, 2026
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Journal Information of This Article
Publication Name
World Journal of Methodology
ISSN
2222-0682
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Senapati SG, Kothawala A, Ahluwalia V, Desai R. High red cell distribution width as a prognostic indicator in heart failure. World J Methodol 2026; 16(1): 108611 [DOI: 10.5662/wjm.v16.i1.108611]
Sidhartha Gautam Senapati, Department of Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, United States
Azra Kothawala, Department of Medicine, Jawaharlal Nehru Medical College, Belgaum 590010, India
Vibhor Ahluwalia, Department of Internal Medicine, Nazareth Hospital, Philadelphia, PA 19152, United States
Rupak Desai, Outcomes Research, Independent Researcher, Atlanta, GA 30079, United States
Author contributions: Senapati SG contributed to the design and implementation of the study and the writing of the manuscript; Kothawala A and Ahluwalia V contributed to the writing of the manuscript; Desai R contributed to the design of the study and the revision of the manuscript; all of the authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sidhartha Gautam Senapati, MD, Department of Internal Medicine, Texas Tech University Health Sciences Center El Paso, 5001 El Paso Drive, El Paso, TX 79905, United States. senapati.sidhartha36@gmail.com
Received: April 18, 2025 Revised: May 30, 2025 Accepted: August 20, 2025 Published online: March 20, 2026 Processing time: 298 Days and 8.3 Hours
Abstract
BACKGROUND
Red cell distribution width (RDW) measures the red blood cell size variation. Elevated RDW has been associated with various adverse health outcomes, including cardiovascular diseases.
AIM
To analyze current evidence on the prognostic significance of high RDW in patients with heart failure (HF).
METHODS
A comprehensive literature search was conducted across multiple databases, including PubMed, EMBASE, and Google Scholar, up to May 2024. Studies were included if they investigated the relationship between RDW levels and outcomes in HF patients. Compared to those in the lowest quartile. The primary outcome was all-cause mortality. Compared to those in the lowest quartile. Heterogeneity was assessed using the I2 statistic, we assessed the impact of individual studies on the overall estimate using a leave-one-out sensitivity analysis and publication bias was evaluated through a contour-enhanced funnel plot and Luis Furuya-Kanamori (LFK) index.
RESULTS
Seven studies, including a total of 11460 HF patients, were analyzed. The participants' mean age varied between 60 years and 80 years, with 6562 (57.26%) in the lower quartile. Patients in the highest quartile of RDW (> 15.21%) had a significantly increased risk of all-cause mortality, with an odds ratio of 1.84 (95%CI: 1.31-2.57, P < 0.001), compared to those in the lowest quartile (RDW: 14.1%-15.20%). There was significant variability in the included studies' results (I2 = 93%, P < 0.01), as well as potential publication bias suggested by the high LFK index (8.47). Sensitivity analysis reinforced the robustness of these findings, showing that the results were not unduly influenced by any single study.
CONCLUSION
This meta-analysis confirms that high RDW is a robust predictor of adverse outcomes in patients with HF, highlighting its potential utility as a simple, cost-effective biomarker for risk stratification. Future research should focus on elucidating the mechanisms underlying this association and exploring the potential benefits of RDW-guided therapeutic strategies in HF management.
Core Tip: Elevated red cell distribution width serves as a simple, cost-effective prognostic marker for adverse outcomes in heart failure (HF) patients, aiding risk stratification and highlighting the need to explore its mechanistic role and therapeutic potential in HF management.
