Relation of Leukocytes and Its Subsets Counts with the Severity of Stable Coronary Artery Disease in Patients with Diabetic Mellitus

Abstract

BackgroundBoth coronary artery disease (CAD) and diabetes mellitus (DM) are associated with inflammation. However, whether and which leukocytes can predict the presence and extent of CAD in patients with DM has not been investigated. The aim of the present study was to examine the association of leukocyte and its subsets counts with the severity of CAD in patients with DM.Methods and FindingsThree hundred and seventy-three diabetic patients who were scheduled for coronary angiography due to typical stable angina pectoris were enrolled in this study. They were classified into the three groups according to tertiles of Gensini score (GS, low group <8, n = 143; intermediate group 8∼28, n = 109; high group >28, n = 121). The relationship between the leukocyte and its subsets counts with the severity of CAD were evaluated. The data indicated that there were significant correlations between leukocyte and neutrophil counts with GS (r = 0.154 and 0.156, respectively, all P<0.003 for Pearson's correlation). Similarly, area under the receivers operating characteristic curve of leukocyte and neutrophil counts were 0.61 and 0.60 respectively (95%CI: 0.55–0.67, all P = 0.001) for predicting high GS. Multivariate logistic regression analysis demonstrated that leukocyte count was an independent predictor for high GS patients with DM (OR = 1.20, 95%CI 1.03–1.39, P = 0.023) after adjusting for conventional risk factors of CAD.ConclusionsCompared with its subsets, leukocyte count appeared to be an independent predictor for the severity of CAD and the optimal cut-off value for predicting high GS (>28 points) was 5.0×109 cells/L in diabetic patients.

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting the Severity of Coronary Artery Disease: A Gensini Score Assessment

“…Thereafter, Tsai J.C. and colleagues studied more than 800 high-risk Korean adult patients (with diabetes mellitus and metabolic syndrome) and determined that NLR was associated with both metabolic syndrome and the risk of ischemic cardiovascular disease 33) . Another prospective study analyzed the predictive ability for cardiac events of the differential WBC count versus was useful, inexpensive and widely available markers of inflammation for predicting the risk and severity of CAD, consistent with the results of our previous study of diabetic patients with stable CAD 17) . In fact, the NLR is a widely available marker of inflammation.…”

“…The levels of WBC, neutrophils, lymphocytes and monocytes were determined using an automated blood cell counter, the Coulter LH780 Hematology Analyzer (Beckman Coulter Ireland Inc. Mervue, Galway, Ireland), and the levels of high-sensitivity C-reactive protein (hs-CRP) were assessed using immunoturbidimetry (Beckmann Assay 360, Bera, California, USA), as previously reported 16,17) . The NLR was calculated as the ratio of neutrophils to lymphocytes, the levels of which were obtained from the same blood samples.…”

Plasma Big Endothelin-1 Level and the Severity of New-onset Stable Coronary Artery Disease

“…All biomarkers were analyzed according to standard hematological and biochemical tests based on our previous study 4) . The plasma big ET-1 level was measured using a highly sensitive and specific commercial sandwich enzyme immunoassay (BI-20082H, Biomedica, Wien, Austria).…”

“…Hence, understanding its predictors would greatly aid in disease prevention and treatment, and the possible relationships between various plasma markers and CAD have intensively been investigated [2][3][4][5] . Among these markers, endothelin 1 (ET-1) has been demonstrated to play a role in endothelial dysfunction and inflammation 6) , both of which are actively involved in the pathophysiology of the onset and progression of CAD, from the formation of atherosclerotic plaque to the development of acute coronary syndrome (ACS) and heart failure following myocardial infarction 7) .…”

Platelet to lymphocyte ratio is associated with the severity of coronary artery disease and clinical outcomes of percutaneous coronary intervention in the Chinese Han population

“…Although counts of leukocytes and their subsets have been demonstrated to be associated with the severity of CAD (10), the relationship between PLR and CAD severity remains unclear. Furthermore, the majority of previous studies have focused on western patients (11)(12)(13).…”