Which leukocyte subsets predict cardiovascular mortality? From the LUdwigshafen RIsk and Cardiovascular Health (LURIC) Study

Research output: Contribution to journalArticle

Authors

  • Bríain Ó Hartaigh
  • G. Neil Thomas
  • Stefan Pilz
  • Adrian Loerbroks
  • Marcus E. Kleber
  • Tanja B. Grammer
  • Joachim E. Fischer
  • Bernhard O. Boehm
  • Winfried März

Abstract

Objective
White blood cells are known to predict cardiovascular mortality, but form a highly heterogeneous population. It is therefore possible that specific subtypes disproportionally contribute to the prediction of cardiovascular outcomes. Therefore, we compared leukocyte subsets alone and in conjunction with an established inflammatory marker, C-reactive protein, for predicting death due to cardiovascular disease in a high-risk population.

Methods
Patients, 3316, (mean [SD] age, 62 [10] years) scheduled for coronary angiography were prospectively followed up. Neutrophil, monocyte and lymphocyte counts were determined. Neutrophil and monocyte subsets were further analysed on the basis of surface expression of CD11b, CD18, CD31, CD40 and CD58. Lymphocytes were further subdivided into CD3, CD4, CD8, and CD19 subsets. The association between each marker and subsequent cardiovascular mortality was assessed using multivariable Cox regression models.

Results
During a median follow-up period of 7.8 years, 745 (22.5%) patients died, of which 484 were due to cardiovascular events. After entering conventional risk factors and removing patients with a current infection, neutrophil count (HR [95% CI] = 1.90 [1.39, 2.60], P < 0.001) and the neutrophil/lymphocyte ratio (HR [95% CI] = 1.68 [1.24, 2.27], P = 0.003) emerged as independent predictors of cardiovascular mortality. After mutual adjustment, neutrophil count (HR [95% CI] = 1.87 [1.35, 2.50], P < 0.001) out-performed C-reactive protein (HR [95% CI] 1.32 [0.99, 1.78], P = 0.06) as a predictor of cardiovascular mortality.

Conclusions
Due to its predictive potential and inexpensive determination, assessment of high neutrophil counts may represent an important marker, possibly improving cardiovascular mortality risk prediction.

Details

Original languageEnglish
Pages (from-to)161-169
JournalAtherosclerosis
Volume224
Issue number1
Early online date8 Jun 2012
Publication statusPublished - 1 Sep 2012

Keywords

  • White blood cell, Cardiovascular disease, Neutrophil, C-reactive protein