ArticleFrontiers in cardiovascular medicine2026
Red cell distribution width: a novel and accessible predictor for immune checkpoint inhibitor-associated myocarditis-a retrospective cohort study.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Immune checkpoint inhibitor (ICI)-associated myocarditis is a rare but potentially fatal immune-related adverse event characterized by high mortality and the absence of specific diagnostic biomarkers. Red blood cell distribution width (RDW), a routine hematologic parameter reflecting erythrocyte volume heterogeneity, has been linked to cardiovascular and inflammatory disease outcomes. However, its diagnostic relevance in ICI-associated myocarditis remains unclear. Methods: A single-center retrospective study was conducted from January 2020 to January 2024, including 51 patients with PD-1 inhibitor-associated myocarditis (case group), 58 patients with viral myocarditis (Control 1), and 50 anti-PD-1-treated patients without myocarditis (Control 2). Clinical and laboratory data, including RDW and troponin T (TnT), were analyzed. Statistical tests included the Kolmogorov-Smirnov test, one-way ANOVA, logistic regression, and receiver operating characteristic (ROC) curve analysis. Results: The mean onset time after PD-1 inhibition therapy was 153.5 ± 184.5 days, and the mean hospitalization period was 13.6 ± 17.5 days, with a survival rate of 33%. RDW was significantly elevated in the case group compared with both control groups ( Conclusion: RDW, an easily obtainable routine laboratory parameter, is independently associated with ICI-associated myocarditis and shows high and comparable diagnostic accuracy relative to TnT. RDW may serve as a practical, noninvasive, complementary auxiliary indicator for early screening and risk stratification of ICI-associated myocarditis.
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