Incidence of Coronary Events and Case Fatality Rate in Relation to Blood Lymphocyte and Neutrophil Counts

• Published in: Arteriosclerosis, thrombosis, and vascular biology Vol. 32; no. 2; pp. 533 - 539
• Main Authors: Adamsson Eryd, Samuel, Smith, J. Gustav, Melander, Olle, Hedblad, Bo, Engström, Gunnar
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Heart Association, Inc 01.02.2012; Lippincott Williams & Wilkins
• Subjects: Aged; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiac and Cardiovascular Systems; Cardiology and Cardiovascular Disease; Cardiology. Vascular system; Clinical Medicine; Coronary heart disease; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Follow-Up Studies; Heart; Humans; Incidence; Kardiologi; Kardiologi och kardiovaskulära sjukdomar; Klinisk medicin; Leukocyte Count; Lymphocyte Count; Lymphocytes - pathology; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Myocardial Infarction - blood; Myocardial Infarction - epidemiology; Myocardial Infarction - mortality; Myocardial Ischemia - blood; Myocardial Ischemia - epidemiology; Myocardial Ischemia - mortality; Neutrophils - pathology; Retrospective Studies; Risk Factors; Survival Rate; Cardiovascular disease; Inflammation; Coronary heart disease; Myocardial disease; Epidemiology; acute coronary syndromes; Incidence; Vascular disease; Atherosclerosis; case fatality rate; Neutrophil; Caucasoid; Acute coronary syndrome; white blood cell count; Blood cell count; Lymphocyte
• DOI: 10.1161/ATVBAHA.111.240416
• ISSN: 1079-5642; 1524-4636

OBJECTIVE—Elevated levels of blood leukocytes have been associated with acute coronary events (CEs), but data on leukocyte subclasses are limited. This study aimed to explore whether blood lymphocyte and neutrophil counts are associated with incidence of CEs and with fatal outcome in subjects who subsequently experienced a first CE. METHODS AND RESULTS—Neutrophil and lymphocyte counts were measured in 27 419 subjects from the general population without a history of CEs, heart failure, or atrial fibrillation. Incidence of CEs was studied in relation to leukocyte counts during a mean follow-up of 13.6 years. Neutrophil but not lymphocyte counts were significantly associated with incidence of CEs. After adjustments for confounding factors, the hazard ratios (95% confidence interval) were 1.00 (reference), 1.07 (0.94–1.23), 1.09 (0.95–1.25), and 1.39 (1.22–1.59) for subjects with neutrophils in the first, second, third, and fourth (highest) sex-specific quartiles, respectively (P for trend <0.001). Of the 1965 subject who had a CE, 471 subjects died on the first day of the CE, in- or outside hospital. The proportions of subjects who died the first day were 19%, 21%, 25%, and 28%, respectively in the first, second, third, and fourth quartiles (P for trend <0.001). CONCLUSION—Increased neutrophil counts are associated with incidence of CEs and increased case-fatality rate after a CE.