Red cell distribution width: a novel and accessible predictor for immune checkpoint inhibitor-associated myocarditis—a retrospective cohort study - Report - MDSpire

Red cell distribution width: a novel and accessible predictor for immune checkpoint inhibitor-associated myocarditis—a retrospective cohort study

  • By

  • Shili Zhong

  • Hao Zhang

  • Meicong Zhao

  • Zhu Yuan

  • Zhen Wang

  • Zhengbin Wu

  • June 26, 2026

  • 0 min

Share

Red Blood Cell Distribution Width as an Indicator for ICI-Associated Myocarditis

Overview

This study investigates the role of red blood cell distribution width (RDW) as a potential diagnostic marker for myocarditis associated with immune checkpoint inhibitors (ICIs). RDW was found to be significantly elevated in patients with ICI-associated myocarditis compared to control groups.

Background

Immune checkpoint inhibitor-associated myocarditis is a rare but serious adverse event with high mortality rates and limited specific diagnostic biomarkers. Identifying reliable indicators for early diagnosis is crucial.

Data Highlights

ParameterCase Group (ICI-Myocarditis)Control 1 (Viral Myocarditis)Control 2 (No Myocarditis)
RDWSignificantly elevated (P < 0.05)NormalNormal
Mean Onset Time153.5 ± 184.5 days--
Mean Hospitalization Period13.6 ± 17.5 days--
Survival Rate33%--
AUC for RDW0.8882--
AUC for TnT0.9102--

Key Findings

  • RDW was significantly elevated in patients with ICI-associated myocarditis compared to both control groups (P < 0.05).
  • Multivariate logistic regression identified RDW (OR = 3.78) and ln(TnT) (OR = 12.12) as independent factors associated with ICI-associated myocarditis.
  • RDW achieved an AUC of 0.8882, indicating high diagnostic accuracy comparable to TnT (AUC = 0.9102).
  • The mean onset time for myocarditis after PD-1 inhibition therapy was 153.5 ± 184.5 days.
  • The mean hospitalization period for affected patients was 13.6 ± 17.5 days.
  • The survival rate among patients with ICI-associated myocarditis was 33%.

Clinical Implications

RDW may serve as a noninvasive marker for early screening of ICI-associated myocarditis.

Conclusion

RDW is independently associated with ICI-associated myocarditis and demonstrates comparable diagnostic accuracy to troponin T.

Related Resources & Content

  1. BMC Psychiatry, Springer, 2025 -- Association between RAR and the prevalence and prognosis of suicidal ideation: evidence from a large population-based study
  2. The ASCO Post -- Studies Explore Cardiac Risks and Clinical Characteristics Associated With Immune Checkpoint Inhibitor–Related Myocarditis
  3. The ASCO Post -- Immune Checkpoint Inhibitors, Cardiovascular Health, and a Potentially Protective Biomarker
  4. The ASCO Post -- Early Myocarditis After Immune Checkpoint Inhibitors Signals Elevated Mortality Risk
  5. 2025 ESC Guidelines for the management of myocarditis and pericarditis
  6. Diagnostic and prognostic parameters for immune checkpoint inhibitor-related myocarditis: A meta-analysis - PubMed
  7. https://www.escardio.org/static-file/Escardio/Guidelines/Products/Slide%20sets/2025/2025%20official%20slides_MyoPeri.pdf
  8. Diagnostic and prognostic parameters for immune checkpoint inhibitor-related myocarditis: A meta-analysis - PubMed

Original Source(s)

Red cell distribution width: a novel and accessible predictor for immune checkpoint inhibitor-associated myocarditis—a retrospective cohort study

  • by Shili Zhong, Hao Zhang, Meicong Zhao, Zhu Yuan, Zhen Wang, Zhengbin Wu

  • June 26, 2026

Related Content

ESMO Breast Cancer 2026 Highlights Panel Discussion

Harold Burstein, MD, PhD; Sara Tolaney, MD, MPH; Erica L. Mayer, MD, MPH; Nancy Lin, MD; and Ana C. Garrido-Castro, MD discuss important breast cancer research presented at the 2026 ESMO Breast Cancer Congress.

  • June 26, 2026

  • 1 min
Solution for the hot spots in adaptive radiotherapy planning for cervical cancer: a case report and review of literature

ESMO Breast Cancer 2026 Highlights: SERENA-6

Harold Burstein, MD, PhD, and Erica Mayer, MD, MPH discuss results from the SERENA-6 trial, which were presented at the 2026 ESMO Breast Cancer Congress.

  • June 26, 2026

  • 1 min