Preprocedural white blood cell count and death after percutaneous coronary intervention

被引:61
作者
Gurm, HS [1 ]
Bhatt, DL [1 ]
Gupta, R [1 ]
Ellis, SG [1 ]
Topol, EJ [1 ]
Lauer, MS [1 ]
机构
[1] Cleveland Clin Fdn, Dept Cardiovasc Med, Cleveland, OH 44195 USA
关键词
D O I
10.1016/S0002-8703(03)00230-8
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Elevated inflammatory markers are associated with worse outcome after percutaneous coronary artery interventions (PCI). An elevation in the white blood cell (WBC) count is a nonspecific response to inflammation. We hypothesized that an elevated WBC count would be a predictor of death in patients undergoing PCI. Methods A total of 4450 patients undergoing percutaneous coronary artery intervention were divided into quintiles, based on their preprocedural WBC count (mean WBC count: quintile 1, 5.08 x 10(3)/muL; quintile 2, 6.58 x 10(3)/muL; quintile 3, 7.70 x 10(3) /muL; quintile 4, 9.14 x 10(3) /muL; and quintile 5, 13.4 x 10(3)/muL). Vital status was assessed through the use of the Social Security Death Index. Results There were a total of 504 deaths over a follow-up period of 48 months. The best survival was seen in quintile 2, with an increase in long-term mortality rates seen with both a higher or a lower WBC count (P <.001). This J-shaped curve was preserved after multivariate adjustment, with the adjusted hazard ratio of mortality relative to quintile 2 being 1.95 (95% Cl, 1.40 to 2.73) in quintile 1, 1.66 (95% CI, 1.18 to 2.33) in quintile 3, 2.31 (95% Cl, 1.67 to 3.17) in quintile 4, and 2.42 (95% Cl, 1.76 to 3.34) in quintile 5. Conclusions A low or an elevated preprocedural WBC count in patients undergoing PCI is associated with an increased risk of long-term death. Our result provides further evidence to support the important role of inflammation in coronary artery disease.
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页码:692 / 698
页数:7
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