Publication Date
6-1-2017
Journal
The Texas Heart Journal
DOI
10.14503/THIJ-16-5768
PMID
28761398
Publication Date(s)
June 2017
Language
English
PMCID
PMC5505396
PubMedCentral® Posted Date
6-1-2017
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Biomarkers/blood, coronary disease/blood, leukocyte count, models, statistical, multivariate analysis, myocardial infarction/blood/mortality, predictive value of tests, risk assessment/methods, survival analysis, time factors
Copyright
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Abstract
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) who had survived acute myocardial infarction. We obtained white blood cell counts and differential counts of white blood cell subtypes within the first 72 hours of hospital admission. The primary outcome was all-cause death at 1, 5, and 10 years after acute myocardial infarction.
In regard to death in the long term, we found significant negative linear associations (lymphocytes), positive linear associations (neutrophils and the neutrophil-to-lymphocyte ratio), and nonlinear U-shaped associations (basophils, eosinophils, monocytes, and total white blood cell count). After multivariate adjustment for the Soroka Acute Myocardial Infarction risk score, lymphocytes (strongest association), neutrophil-to-lymphocyte ratio, and eosinophils were independently associated with death for up to 10 years after hospital discharge. The independent associations weakened over time.
We conclude that lymphocyte count, neutrophil-to-lymphocyte ratio, and eosinophil count are independently and incrementally associated with death in the long term after acute myocardial infarction.