Prognostic Value of Red Cell Distribution Width in Acute Coronary Syndrome

Anisocytosis denotes the presence of unequal sizes of erythrocytes in the circulation and may signify the development of nutritional deficiency anemias, sickle cell anemia, hemolytic anemia, myelodysplastic syndrome, and other hematological disorders. Red cell distribution width (RDW), a quantitative measure of the magnitude of anisocytosis, is routinely reported as a part of complete blood count by automated instruments in hematology laboratories. An elevated RDW is commonly used in the differential diagnoses of nutritional deficiency anemias and thalassemias. Rapidly accruing evidence indicates that RDW may offer prognostic information regarding the clinical outcomes in various cardiovascular scenarios. This article aims to review the current knowledge concerning the predictive value of RDW in patients with acute coronary syndrome. Elevated RDW is a strong predictor for mortality and major adverse cardiac events among patients admitted with acute myocardial infarction. When incorporated into conventional risk assessment models, RDW also enhances the performance in predicting cardiovascular outcome. In light of its wide availability, low cost and common use, future research should consider RDW measurement in the risk stratification schemes for patients with coronary artery disease.