Significance of white blood cell count and its subtypes in patients with acute coronary syndrome

Huang, Guan‐Hua; Zhong, Xiaogang; Zhong, Bin; Chen, Y.-Q.; Liu, Z.-Z.; Li, Su; Ling, Zhiyu; Cao, Hua; Yin, Yuehui

doi:10.1111/j.1365-2362.2009.02107.x

Cited by 49 publications

(46 citation statements)

References 36 publications

(43 reference statements)

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“…39 Consistent with these reports, we found that the lymphocyte count was the strongest independent predictor of long-term death after AMI. Conversely, Huang and colleagues 29 did not find a significant correlation between lymphocyte count and MACE in ACS patients, although the count did predict stenosis greater than 75% on coronary angiography. This discrepancy with the current study could result from different outcomes (MACE vs death), inclusion criteria (ACS vs AMI), and smaller study groups that precluded statistical significance.…”

Section: Continues On Next Pagementioning

confidence: 84%

“…26 In a systematic review, including 21 studies and more than 34,000 patients, a signif icant relationship between clinical outcomes and neutrophils, measured as abso- 27 More specifically, several investigators showed that neutrophils measured within 24 hours after symptom onset were long-term predictors of death after AMI and ACS. [27][28][29] Conversely, Zouridakis and associates 30 found no correlation between neutrophils and clinical outcomes (death after hospital discharge meshed with other clinical outcomes). In the current study, an increased neutrophil count (especially in Q4) was associated with higher long-term mortality rates in the univariate analysis, but not in the multivariate analysis.…”

Section: Discussionmentioning

confidence: 97%

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White Blood Cell Subtypes Are Associated with a Greater Long-Term Risk of Death after Acute Myocardial Infarction

Shiyovich¹,

Gilutz²,

Plakht³

2017

Texas Heart Institute Journal

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We evaluated the association between white blood cell counts and long-term mortality rates in 2,129 patients (mean age, 65.3 ± 13.5 yr; 69% men) L ong-term risk stratification after acute myocardial infarction (AMI) is of great importance, because the benefits of costly interventions and medical treatments are greatest in patients who are at higher risk.1 Evidence indicates that inflammation plays a crucial role in the atherosclerotic process, from its initiation, progression, plaque destabilization, triggering of an acute coronary event, and infarction size, to recuperation after AMI has occurred.2-4 Moreover, it has been postulated that the greater the inflammatory response during the acute phase of AMI, the greater the proinflammatory activity during chronic (stable) phases of the disease.5 Several inflammatory biomarkers (such as C-reactive protein and lipoprotein-associated phospholipase A 2 ) have been identified as important for risk stratification after AMI. 6,7 The circulating white blood cell (WBC) count and differential counts are simple, inexpensive-to-test, and readily available inflammatory markers 8 that have been associated with event rates in patients with coronary heart disease. 9,10 In addition, investigators have related high WBC count to death after AMI.11,12 Moreover, Taglieri and colleagues 13 have reported that WBC count is an independent predictor of 3-year death in patients with non-ST-segment-elevation acute coronary syndrome (ACS), yet this predictor did not add prognostic information beyond the Global Registry of Acute Coronary Events (Grace) score. However, prognosis was usually evaluated for a relatively short time in most studies. Investigators have often included WBC count without subtypes, included only a few subtypes, or applied incomparable methodologies. The independent prognostic value of WBC count and its subtypes, adjusted to other risk factors, has been debatable, and its evaluation as part of post-AMI prognostication has not been performed often.We investigated the association of total and differential WBC counts in regard to long-term mortality rates (at 1-, 5-, and 10-yr follow-up) and evaluated the latter values as incremental predictors with use of a validated prognostic tool: the Soroka Acute Myocardial Infarction (SAMI) score, which integrates cardiovascular risk factors and affective comorbidities into an index score.

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Section: Continues On Next Pagementioning

confidence: 84%

Section: Discussionmentioning

confidence: 97%

White Blood Cell Subtypes Are Associated with a Greater Long-Term Risk of Death after Acute Myocardial Infarction

Shiyovich¹,

Gilutz²,

Plakht³

2017

Texas Heart Institute Journal

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“…The change in blood leukocyte counts signifies an immune response to unfavourable or abnormal situations [41]. Several studies have previously reported an association between leukocyte counts and cardiovascular disease [42], but now also peptic ulceration [43]. Besides, the neutrophil to lymphocyte count ratio (NLR) is now being regarded as a useful and reliable parameter for assessing some clinical problems ranging from cardiovascular events to cancer [44].…”

Section: Discussionmentioning

confidence: 99%

Folic Acid Supplementation Ameliorates Inflammation and Apoptosis in Ethanol-Induced Gastric Ulceration in Rats

Ajeigbe¹,

Jaja²,

Onifade³

et al. 2017

JBM

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Although the gastroprotective potential of folic acid has been reported, little is known about the role of inflammation and apoptosis in the said activity. This study, therefore, assessed lipid peroxidation (LPO), Neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP) as markers of inflammation and, p53 and BCl-2 as markers of apoptosis in ethanol-induced gastric ulcer pretreated with Folic acid (FA) for twenty-one (21) days. Adult male Wistar rats were arranged into experimental groups (n = 5) viz: 1) Control; 2) Ulcer control; 3) 2FA (2 mg/kg folic acid + Ulcer); 4) 3FA (3 mg/kg folic acid + Ulcer); 5) OMEP (20 mg/kg omeprazole + Ulcer); 6) 2FA + OMEP + Ulcer; and 7) 3FA + OMEP + Ulcer. Ulcer score, LPO, NLR, serum CRP were all determined one hour post ulcer induction. Paraffin gastric sections were stained first with H & E, then immunostained for p53 and BCl-2. Ethanol caused gastric lesion with an index of 3.0 ± 0.2. Ulcer severity and LPO was significantly decreased in the 2FA, 3FA, OMEP, 2FA + OMEP and 3FA + OMEP groups. NLR reduced significantly in the 2FA, 3FA, OMEP and OMEP + 3FA group. Qualitatively, there was absence of C-reactive protein in the 2FA group while quantitatively, presence of CRP appeared sustained in the 3FA and OMEP treated groups. Unlike p53, the expression and labeling index of BCl-2 were significantly enhanced more in the FA and OMEP combination than OMEP alone. Folic acid ameliorates the development of gastric ulcer in rats via its anti-inflammatory and anti-apoptotic activities.

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“…Monocyte count may predict the severity of atherosclerotic stenosis and coronary plaque progression in acute coronary syndromes [41,55]. Moreover, Waterhouse et al (2008) suggested that of all white blood cell types, monocyte count has the strongest positive and independent relationship with CAD risk in asymptomatic adults [56].…”

Section: The Process Of Atherosclerosis -Main Pointsmentioning

confidence: 99%

“…Several studies showed that high neutrophil count or neutrophil-to-lymphocyte ratio is associated with coronary stenosis, and may predict CAD and major adverse cardiac events such as myocardial infarction [37][38][39][40][41][42]. Neutrophil activation is widely observed in unstable angina [43,44], however, the state of neutrophils in stable angina pectoris patients appears to be controversial [31,45] and requires more investigation.…”

Section: The Process Of Atherosclerosis -Main Pointsmentioning

confidence: 99%

Characterization of the psycho-neuro-immunological state in patients with coronary artery disease

Serfőző¹

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Significance of white blood cell count and its subtypes in patients with acute coronary syndrome

Abstract: Neutrophil count adds prognostic information to MACEs in ACS. Monocyte count and lymphocyte count are predictive of severity of coronary atherosclerosis.

Cited by 49 publications

References 36 publications

White Blood Cell Subtypes Are Associated with a Greater Long-Term Risk of Death after Acute Myocardial Infarction

White Blood Cell Subtypes Are Associated with a Greater Long-Term Risk of Death after Acute Myocardial Infarction

Folic Acid Supplementation Ameliorates Inflammation and Apoptosis in Ethanol-Induced Gastric Ulceration in Rats

Characterization of the psycho-neuro-immunological state in patients with coronary artery disease

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