Usefulness of Relative Lymphocyte Count as an Independent Predictor of Death/Urgent Transplant in Heart Failure

Huehnergarth, Kier V.; Mozaffarian, Dariush; Sullivan, Mark D.; Crane, Barbara; Wilkinson, Charles W.; Lawler, Richard L.; McDonald, George B.; Fishbein, Daniel P.; Levy, Wayne C.

doi:10.1016/j.amjcard.2005.02.022

Cited by 60 publications

(47 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several previous studies conducted in patients with chronic HF in stable outpatients have shown that lymphocyte counts (using different cutoffs and definitions) predict survival up to 1 year after measurement. [4][5][6][7] These findings have been extended to special populations including patients with advanced chronic HF being evaluated for transplantation 20 and patients with implantable cardioverter-defibrillators. 21 Less data are available evaluating the association between baseline lymphocyte counts and outcomes in HHF.…”

Section: Discussionmentioning

confidence: 99%

“…Few small studies have suggested that lymphopenia may confer increased risk for mortality in stable outpatients [4][5][6][7] and patients with HHF. [8][9][10][11] Although low lymphocyte count is currently recognized in certain risk stratification scores for chronic heart failure, 12 contemporary HHF prognostication models lack inclusion of this potentially valuable parameter.…”

Section: Clinical Perspective On P 758mentioning

confidence: 99%

See 1 more Smart Citation

Predictive Value of Low Relative Lymphocyte Count in Patients Hospitalized for Heart Failure With Reduced Ejection Fraction

Vaduganathan

Ambrosy

Greene

et al. 2012

Circ: Heart Failure

104

View full text Add to dashboard Cite

Background-Low lymphocyte count has been shown to be an independent prognostic marker in heart failure (HF) in the outpatient setting. Limited data exist regarding whether relative lymphocyte count correlates with postdischarge outcomes in patients hospitalized for HF. Methods and Results-We performed a post hoc analysis of the Efficacy of Vasopressin Antagonism in Heart FailureOutcome Study with Tolvaptan (EVEREST) trial, which randomized 4133 patients hospitalized for worsening HF with an ejection fraction ≤40% within 48 hours of admission to tolvaptan or placebo for a median follow-up of 9.9 months. The primary end points of all-cause mortality and cardiovascular mortality or HF hospitalization were analyzed in patients with available baseline complete blood counts (n=3717). Lymphocyte percentage was analyzed as a continuous variable. Times to events were compared using log-rank tests and multivariable Cox regression models. Patients with low lymphocyte percentage tended to be older and had higher rates of comorbid disease (diabetes mellitus, atrial fibrillation, and renal insufficiency). Low lymphocyte counts were associated with wide QRS duration, high natriuretic peptides, and low ejection fraction, blood pressure, and serum sodium. These patients were less likely to receive evidence-based HF medications. After adjusting for 22 known clinical risk factors, a 10% decrease in lymphocytes was associated with an increased hazard of all-cause mortality (adjusted hazard ratio 1.31 [95% CI: 1.14-1.150], P<0.001) and cardiovascular mortality or HF hospitalization (adjusted hazard ratio 1.14 [95% CI: 1.04-1.25], P=0.007) in the first 100 days postdischarge. Lymphopenia during hospitalization normalizes in majority of patients in the early postdischarge period. Conclusions-Low relative lymphocyte count during hospitalization for HF is an independent predictor of poor outcomes in the early postdischarge period, beyond traditional prognostic indicators. (Circ Heart Fail. 2012;5:750-758.)

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Clinical Perspective On P 758mentioning

confidence: 99%

Predictive Value of Low Relative Lymphocyte Count in Patients Hospitalized for Heart Failure With Reduced Ejection Fraction

Vaduganathan

Ambrosy

Greene

et al. 2012

Circ: Heart Failure

104

View full text Add to dashboard Cite

show abstract

“…Relation between neutrophil/lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), relative lymphocyte count (L%), and heart failure aetiology according to response to cardiac resynchronisation therapy count [18,19]. Previous studies have shown that relative lymphocyte count was significantly associated with incident HF, hospitalisations due to HF, and mortality [20][21][22]. Neutrophils play a major role in the inflammatory process, by producing myeloperoxidase that promotes phagocytic function.…”

Section: Discussionmentioning

confidence: 99%

The role of baseline indirect inflammatory markers in prediction of response to cardiac resynchronisation therapy

Balcı

Şen

et al. 2016

Kardiol Pol

View full text Add to dashboard Cite

A b s t r a c tBackground: In many cardiovascular diseases (CVD), white blood cell counts with differentials are used to predict adverse events. Both platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are studied in various CVDs. Aim:The role of inflammatory condition assessed using routine laboratory tests in cardiac resynchronisation therapy (CRT) response has not been investigated thoroughly. Therefore, we aimed to assess the association of NLR, PLR, and relative lymphocyte count (L%) with response to CRT. Methods:A total of 157 patients (76.4% male; mean age 58.7 ± 11.8 years) who underwent CRT implantation at our tertiary referral hospital were retrospectively analysed.Results: Among included patients, a total of 50 (31.8%) patients were defined as "non-responders". Median NLR and PLR were significantly higher in the non-responder group (p < 0.001), and median L% was significantly lower in the non-responder group (p < 0.001). Also, median NLR was significantly higher in patients with New York heart Association (NYHA) class II-III when compared to patients with NYHA class I after six months of CRT implantation (p < 0.001, p = 0.004, respectively). Correlation analysis demonstrated a positive correlation between paced QRS duration and NLR (p = 0.031) and a negative correlation between paced QRS duration and L% (p = 0.002). In addition, both NLR and L% showed significant correlations with post-procedural NYHA functional classes (p < 0.001; p = 0.008, respectively). Patients with PLR > 173.09 had a 2.9-fold and NLR > 3.45 had a 12.2-fold increased risk of CRT nonresponse, respectively. Conclusions:In the current study non-responders to CRT had higher NLR and PLR and lower L%, which may support the deleterious effects of baseline inflammatory condition in advanced heart failure.

show abstract

“…7 An interesting observation is that the fraction of leukocytes provides additional prognostic information. In fact, it was already demonstrated that low lymphocyte count was predictive of all-cause mortality or heart transplantation, 49 later confirmed in the population from the EVEREST trial. 30 The mechanism is not entirely clear, but this may be due to splanchnic congestion causing enteric loss of lymphocytes.…”

Section: 2945mentioning

confidence: 89%

Prognostic value of novel biomarkers compared with detailed biochemical evaluation in patients with heart failure

Rywik¹,

Janas²,

Klisiewicz³

et al. 2015

Polish Archives of Internal Medicine

View full text Add to dashboard Cite

Usefulness of Relative Lymphocyte Count as an Independent Predictor of Death/Urgent Transplant in Heart Failure

Cited by 60 publications

References 15 publications

Predictive Value of Low Relative Lymphocyte Count in Patients Hospitalized for Heart Failure With Reduced Ejection Fraction

Predictive Value of Low Relative Lymphocyte Count in Patients Hospitalized for Heart Failure With Reduced Ejection Fraction

The role of baseline indirect inflammatory markers in prediction of response to cardiac resynchronisation therapy

Prognostic value of novel biomarkers compared with detailed biochemical evaluation in patients with heart failure

Contact Info

Product

Resources

About