Does smoking status affect the association between baseline white blood cell count and in-hospital mortality of patients presented with Acute Coronary Syndrome? The Greek study of Acute Coronary Syndromes (GREECS)

Pitsavos, Christos; Kourlaba, Georgia; Panagiotakos, Demosthenes B.; Tsamis, Eleftherios; Kogias, Yannis; Stravopodis, Peter; Stefanadis, Christodoulos

doi:10.1016/j.ijcard.2007.05.030

Cited by 8 publications

(5 citation statements)

References 37 publications

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“…Chronic periodontitis patients exhibit a significantly high WBC count, which is also a surrogate marker of the inflammatory response and a potential marker of plaque instability. Smoking further increases the WBC count that is again a risk factor for ACS . As described, smokers formed 41.66% of group 1 subjects suggested that smoking added to the periodontal inflammatory burden, which leads to a significantly elevated WBC count, which is an independent predictor of plaque instability and ACS.…”

Section: Discussionmentioning

confidence: 81%

Dysregulation of miR‐146a by periodontal pathogens: A risk for acute coronary syndrome

Gita

George

Pavithra

et al. 2019

Journal of Periodontology

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Background: Periodontitis is a polymicrobial, chronic inflammatory disease leading to loss of tooth-supporting structures. The bacteremia, endotoxemia, and systemic low-grade inflammation associate periodontitis with systemic illnesses such as diabetes mellitus and coronary artery disease. Periodontal pathogens have been detected from atheromatous plaque by amplification of the genetic material by using specific oligonucleotide primers in polymerase chain reaction. Though the association between periodontitis and cardiovascular diseases has been ascertained by systematic reviews and meta-analyses, its pathophysiology is not lucid. MicroRNAs are currently implicated in the regulation of many cellular processes including inflammation and may play a vital role in our understanding of this disease association. In this casecontrol study, we explored the role of the inflammatory microRNA, miR-146a, in acute coronary syndrome (ACS) subjects with and without chronic periodontitis (CP) and its regulation of the innate immune host response to periodontal pathogens.Methods: Three groups each comprising 66 patients each, namely group 1 (ACS patients without CP), group 2 (ACS patients with CP) and group 3 (CP only) formed the study population. Subgingival plaque samples and serum samples were subjected to quantitative Polymerase Chain Reaction (qPCR) for detection of Porphyromonas gingivalis, a keystone pathogen and to assess the levels of circulating miR-146a and associated proinflammatory cytokines.Results: miR-146a associated significantly in group 2 subjects with an odds ratio 1.434, 95% confidence interval 1.013-2.030, P < 0.042, and a predictive percentage of 83.3% and group 1 with a predictive percentage of 76.0.% The associated cytokines interleukin-6 (IL-6), tumor necrosis factor-, and IL-1 also showed an upregulation with statistical significance (P < 0.05).Conclusion: microRNA-146a is a key molecule associating periodontitis with acute coronary syndrome. K E Y W O R D Sacute coronary syndrome, chronic inflammation, chronic periodontitis, immune subversion, miR-146a, Porphyromonas gingivalis756

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Section: Discussionmentioning

confidence: 81%

Dysregulation of miR‐146a by periodontal pathogens: A risk for acute coronary syndrome

Gita

George

Pavithra

et al. 2019

Journal of Periodontology

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“…As we revealed in our study that the initial WBC count seems to be higher in younger patients, who more frequently suffer from myocardial infarction rather than unstable angina, have higher heart rate at entry, have higher troponin I levels, have less frequently prior history of coronary heart disease, and are more often current smokers (Table 2). These correlations are more or less expected and form a patient profile that is previously linked to congestive heart failure occurence after an ACS [15], while smoking is recently also associated with WBC count and worse hospital and short-term prognosis in an analysis from GREECS study [16]. …”

Section: Discussionmentioning

confidence: 91%

Comparative Value of Simple Inflammatory Markers in the Prediction of Left Ventricular Systolic Dysfunction in Postacute Coronary Syndrome Patients

Aggelopoulos

Chrysοhoou

Pitsavos

et al. 2009

Mediators of Inflammation

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Objectives. We sought to assess the comparative value of inflammatory markers on the occurrence of left ventricular systolic dysfunction (LVSD) after an acute coronary syndrome (ACS). Methods. During 2006–2008, 760 patients with an ACS were enrolled. C-reactive protein (CRP) and white blood cell (WBC) count were measured during the first 12 hours of hospital admission. Results. CRP levels and WBC count were significantly higher in those who developed LVSD compared to those who did not. The analysis revealed that a 10 mg/dL increase of CRP levels and a 1000/μL increase in WBC are associated with a 6% and a 7% increase in the likelihood of developing LVSD, respectively. Furthermore, WBC count at entry and CRP have almost the same predictive value for development of LVSD after an ACS (R 2 = 0.109 versus R 2 = 0.093). Conclusions. Serum CRP levels and WBC count at entry are almost equally powerful independent predictors of LVSD, after an ACS.

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“…White blood cells count increase has been associated with a greater risk of cardiovascular events [24], and it has been also suggested that leukocytosis may serve as an important biomarker for these diseases [25,26]. Furthermore, it has also been shown that smoking status modiWes white blood cell count and in-hospital mortality of patients aVected by acute coronary syndrome suggesting that in these patients, the increase of white cells count is a predictor of mortality among smokers [27]. Recently, we showed that the increased white cells count can be detected early in the life of smokers since it can be high even after the Wrst decade of smoking [12,28].…”

Section: Discussionmentioning

confidence: 99%

White cells count in smokers affected by rheumatic diseases

et al. 2010

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Evidence shows that tobacco smoking interacts with development of rheumatic diseases. Increase in white cells count (leukocytosis) is frequently present, and in smokers, it is considered a biomarker of cardiovascular risk. Aim of the study is to evaluate this biomarker in smokers with rheumatic diagnosis. We carried out an observational study on 115 rheumatic outpatients (26 men and 89 women) divided into two groups according to their smoking habit: one composed of 56 smokers, the other of 59 not smokers. Diagnosis and common routinary clinical parameters were collected. In the total sample, smokers were 48.69%. Most common diagnosis was osteoarthritis (OA) (40.87% of the total); smokers in OA women were 36.11%, smokers in OA men were 54.55%. Second most common diagnosis was rheumatoid arthritis (RA) (23.48% of the total); smokers in RA women were 40.91%; smokers in RA men were 80%. OA smokers showed a significant increase (P < 0.05) in white cells count when compared with OA not smokers. Between RA smokers and not smokers, any clinical difference was found. RA subjects following regular pharmacological treatment in the last 2 months were 84.61%. OA patients treated with drugs in the last 2 months were only 22.2%. Results seem to confirm that smoking habit may influence the development as well as gender distribution of rheumatic diseases. They show also that in absence of pharmacological treatment in smokers affected by OA leukocytosis (biomarker of cardiovascular risk) is observed.

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Does smoking status affect the association between baseline white blood cell count and in-hospital mortality of patients presented with Acute Coronary Syndrome? The Greek study of Acute Coronary Syndromes (GREECS)

Cited by 8 publications

References 37 publications

Dysregulation of miR‐146a by periodontal pathogens: A risk for acute coronary syndrome

Dysregulation of miR‐146a by periodontal pathogens: A risk for acute coronary syndrome

Comparative Value of Simple Inflammatory Markers in the Prediction of Left Ventricular Systolic Dysfunction in Postacute Coronary Syndrome Patients

White cells count in smokers affected by rheumatic diseases

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