Effect of statins and white blood cell count on mortality in patients with ischemic left ventricular dysfunction undergoing percutaneous coronary intervention

Lipinski, Jerry; Martin, Robert E.; Cowley, Michael J.; Goudreau, Evelyne; Malloy, Walter N.; Johnson, Robert E.; Vetrovec, George W.

doi:10.1002/clc.4960290109

Cited by 9 publications

(4 citation statements)

References 23 publications

(33 reference statements)

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“…In the present meta-analysis, approach-related bleeding events represented only about 1% when compared to an overall rate of 7%. When compared to large randomized controlled trials comparing radial versus femoral access in STEMI patients [ 34 – 36 ], the lower incidence of access-related bleeding is confirmed, while in the present paper an overall higher rate of hemorrhages is present, probably due to inclusion also of NSTEMI patients, who usually present with higher rates of comorbidity [ 1 , 3 , 4 ]. It is important to note that CRUSADE was the only score externally validated in NSTEMI patients, while the other two were tested for all myocardial infarction or only STEMI.…”

Section: Discussionsupporting

confidence: 68%

Accuracy of bleeding scores for patients presenting with myocardial infarction: a meta-analysis of 9 studies and 13 759 patients

Taha¹,

D’Ascenzo²,

Moretti³

et al. 2015

pwki

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IntroductionDue to its negative impact on prognosis, a clear assessment of bleeding risk for patients presenting with acute coronary syndrome (ACS) remains crucial. Different risk scores have been proposed and compared, although with inconsistent results.AimWe performed a meta-analysis to evaluate the accuracy of different bleeding risk scores for ACS patients.Material and methodsAll studies externally validating risk scores for bleeding for patients presenting with ACS were included in the present review. Accuracy of risk scores for external validation cohorts to predict major bleeding in patients with ACS was the primary end point. Sensitivity analysis was performed according to clinical presentation (ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI)).ResultsNine studies and 13 759 patients were included. CRUSADE, ACUITY, ACTION and GRACE were the scores externally validated. The rate of in-hospital major bleeding was 7.80% (5.5–9.2), 2.05% (1.5–3.0) being related to access and 2.70% (1.7–4.0) needing transfusions. When evaluating all ACS patients, ACTION, CRUSADE and ACUITY performed similarly (AUC 0.75: 0.72–0.79; 0.71: 0.64–0.80 and 0.71: 0.63–0.77 respectively) when compared to GRACE (0.66; 0.64–0.67, all confidence intervals 95%). When appraising only STEMI patients, all the scores performed similarly, while CRUSADE was the only one externally validated for NSTEMI. For ACTION and ACUITY, accuracy increased for radial access patients, while no differences were found for CRUSADE.ConclusionsACTION, CRUSADE and ACUITY perform similarly to predict risk of bleeding in ACS patients. The CRUSADE score is the only one externally validated for NSTEMI, while accuracy of the scores increased with radial access.

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Section: Discussionsupporting

confidence: 68%

Accuracy of bleeding scores for patients presenting with myocardial infarction: a meta-analysis of 9 studies and 13 759 patients

Taha¹,

D’Ascenzo²,

Moretti³

et al. 2015

pwki

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“…Nonetheless, as CD19, CD20, CD27, and CD43 positive B cells spontaneously produces IgM, further study is required to determine if these cells produce NAb to OSE, determine if numbers of circulating CD19, CD20, CD27, and CD43 positive B cells are associated with circulating levels of NAb to OSE and atherosclerosis. It has been well established that leukocytosis is independently associated with CAD [63] and poor outcomes after cardiovascular events [64–66] suggesting that circulating leukocyte counts can act as biomarkers for disease progression and outcome. Though less established, it has been shown that circulating lymphocyte counts show an inverse relationship to recurrent ischemic events and cardiovascular mortality [63].…”

Section: B Cells In Human Vascular Diseasementioning

confidence: 99%

Understanding the role of B cells in atherosclerosis: potential clinical implications

Morris-Rosenfeld¹,

Lipinski²,

McNamara³

2013

Expert Review of Clinical Immunology

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Atherosclerosis is a progressive inflammatory disease of the medium to large arteries that is the largest contributor to cardiovascular disease (CVD). B cell subsets have been shown in animal models of atherosclerosis to have both atherogenic and atheroprotective properties. In this review we highlight the research that developed our understanding of the role of B cells in atherosclerosis both in humans and mice. From this we discuss the potential clinical impact B cells could have both as diagnostic biomarkers and as targets for immunotherapy. Finally, we recognize the inherent difficulty in translating findings from animal models into humans given the differences in both cardivascular disease and the immune system between mice and humans, making the case for greater efforts at addressing the role of B cells in humans atherosclerosis.

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“…Lipinski et al [19] studied patients with poor left ventricular function and evaluated the relationship between statins and white blood cell counts. The investigators could predict the patients who would benefit from the statin in terms of late outcome based on those who had higher white counts, suggesting more inflammation at the time of the procedure.…”

Section: Special Subgroupsmentioning

confidence: 99%

Evidence‐based management of patients undergoing PCI: Stent controversies

Vetrovec

2010

Cathet Cardio Intervent

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Drug-eluting stents reduce restenosis, particularly in uncomplicated lesions. Despite limited on-label indications, drug-eluting stents have been universally adopted. However, there have been early sporadic reports of stent thrombosis. This article will review the risk factors for stent thrombosis and will briefly discuss recent trials comparing the safety, efficacy, and mortality for bare-metal and drug-eluting stents.

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Effect of statins and white blood cell count on mortality in patients with ischemic left ventricular dysfunction undergoing percutaneous coronary intervention

Cited by 9 publications

References 23 publications

Accuracy of bleeding scores for patients presenting with myocardial infarction: a meta-analysis of 9 studies and 13 759 patients

Accuracy of bleeding scores for patients presenting with myocardial infarction: a meta-analysis of 9 studies and 13 759 patients

Understanding the role of B cells in atherosclerosis: potential clinical implications

Evidence‐based management of patients undergoing PCI: Stent controversies

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