Int J Angiol 2015; 24(02): 127-132
DOI: 10.1055/s-0035-1544178
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Blood Leukocyte Count on Admission Predicts Cardiovascular Events in Patients with Acute Non-ST Elevation Myocardial Infarction

Surya Dharma
1   Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
,
Rosmarini Hapsari
1   Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
,
Bambang B. Siswanto
1   Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
,
Arnoud van der Laarse
2   Department of Cardiology and Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
,
J. Wouter Jukema
3   Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
› Author Affiliations
Further Information

Publication History

Publication Date:
28 January 2015 (online)

Abstract

We aim to test the hypothesis that blood leukocyte count adds prognostic information in patients with acute non–ST-elevation myocardial infarction (non-STEMI).

A total of 585 patients with acute non-STEMI (thrombolysis in myocardial infarction risk score ≥ 3) were enrolled in this cohort retrospective study. Blood leukocyte count was measured immediately after admission in the emergency department. The composite of death, reinfarction, urgent revascularization, and stroke during hospitalization were defined as the primary end point of the study.

The mean age of the patients was 61 ± 9.6 years and most of them were male (79%). Using multivariate Cox regression analysis involving seven variables (history of smoking, hypertension, heart rate > 100 beats/minute, serum creatinine level > 1.5 mg/dL, blood leukocyte count > 11,000/µL, use of β-blocker, and use of angiotensin-converting enzyme inhibitor), leukocyte count > 11,000/µL demonstrated to be a strong predictor of the primary end point (hazard ratio = 3.028; 95% confidence interval = 1.69–5.40, p < 0.001).

The high blood leukocyte count on admission is an independent predictor of cardiovascular events in patients with acute non-STEMI.

Note

This article is original and has not been published or being submitted elsewhere.


 
  • References

  • 1 Kinlay S, Selwyn AP, Libby P, Ganz P. Inflammation, the endothelium, and the acute coronary syndromes. J Cardiovasc Pharmacol 1998; 32 (Suppl. 03) S62-S66
  • 2 Libby P. Molecular bases of the acute coronary syndromes. Circulation 1995; 91 (11) 2844-2850
  • 3 Libby P, Ridker PM, Hansson GK. Inflammation in atherosclerosis: from pathophysiology to practice. J Am Coll Cardiol 2009; 54 (23) 2129-2138
  • 4 Khuseyinova N, Koenig W. Biomarkers of outcome from cardiovascular disease. Curr Opin Crit Care 2006; 12 (5) 412-419
  • 5 Madjid M, Awan I, Willerson JT, Casscells SW. Leukocyte count and coronary heart disease: implications for risk assessment. J Am Coll Cardiol 2004; 44 (10) 1945-1956
  • 6 Brown DW, Giles WH, Croft JB. White blood cell count: an independent predictor of coronary heart disease mortality among a national cohort. J Clin Epidemiol 2001; 54 (3) 316-322
  • 7 Lee CD, Folsom AR, Nieto FJ, Chambless LE, Shahar E, Wolfe DA. White blood cell count and incidence of coronary heart disease and ischemic stroke and mortality from cardiovascular disease in African-American and White men and women: atherosclerosis risk in communities study. Am J Epidemiol 2001; 154 (8) 758-764
  • 8 Takeda Y, Suzuki S, Fukutomi T , et al. Elevated white blood cell count as a risk factor of coronary artery disease: inconsistency between forms of the disease. Jpn Heart J 2003; 44 (2) 201-211
  • 9 Barron HV, Harr SD, Radford MJ, Wang Y, Krumholz HM. The association between white blood cell count and acute myocardial infarction mortality in patients > or = 65 years of age: findings from the cooperative cardiovascular project. J Am Coll Cardiol 2001; 38 (6) 1654-1661
  • 10 Cannon CP, McCabe CH, Wilcox RG, Bentley JH, Braunwald E , the OPUS-TIMI 16 Investigators. Association of white blood cell count with increased mortality in acute myocardial infarction and unstable angina pectoris. OPUS-TIMI 16 Investigators. Am J Cardiol 2001; 87 (5) 636-639 , A10
  • 11 Mueller C, Neumann FJ, Perruchoud AP, Buettner HJ. White blood cell count and long term mortality after non-ST elevation acute coronary syndrome treated with very early revascularisation. Heart 2003; 89 (4) 389-392
  • 12 Byrne CE, Fitzgerald A, Cannon CP, Fitzgerald DJ, Shields DC. Elevated white cell count in acute coronary syndromes: relationship to variants in inflammatory and thrombotic genes. BMC Med Genet 2004; 5: 13
  • 13 Antman EM, Cohen M, Bernink PJLM , et al. The TIMI risk score for unstable angina/non-ST elevation MI: a method for prognostication and therapeutic decision making. JAMA 2000; 284 (7) 835-842
  • 14 Neumann FJ, Ott I, Marx N , et al. Effect of human recombinant interleukin-6 and interleukin-8 on monocyte procoagulant activity. Arterioscler Thromb Vasc Biol 1997; 17 (12) 3399-3405
  • 15 Bovill EG, Bild DE, Heiss G , et al. White blood cell counts in persons aged 65 years or more from the Cardiovascular Health Study. Correlations with baseline clinical and demographic characteristics. Am J Epidemiol 1996; 143 (11) 1107-1115
  • 16 de Gaetano G, Cerletti C, Evangelista V. Recent advances in platelet-polymorphonuclear leukocyte interaction. Haemostasis 1999; 29 (1) 41-49
  • 17 Morange PE, Simon C, Alessi MC , et al; PRIME Study Group. Endothelial cell markers and the risk of coronary heart disease: the Prospective Epidemiological Study of Myocardial Infarction (PRIME) study. Circulation 2004; 109 (11) 1343-1348
  • 18 Granger CB, Goldberg RJ, Dabbous O , et al; For the Global Registry of Acute Coronary Events Investigators. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med 2003; 163 (19) 2345-2353
  • 19 Dharma S, Juzar DA, Firdaus I, Soerianata S, Wardeh AJ, Jukema JW. Acute myocardial infarction system of care in the third world. Neth Heart J 2012; 20 (6) 254-259