Association Of Peripheral White Blood Cell And Its Subtypes With Maces In Coronary Atherosclerotic Heart Disease

Background: Inflammation has been shown to play a role in atherosclerosis.Objective: To investigate the association of peripheral white blood cell and its subtypes with MACEs in coronary atherosclerotic heart disease.Methods: 678 patients with coronary atherosclerotic heart disease referred for Coronary Angiography for the first time in our hospital were enrolled in this study. Total White Blood Cell count and its subgroups were measured on admisson. The study population was divided into three groups based on total white blood cell count and followed up. Clinical end points were Major Adverse Cardiovascular Events (MACEs).Results: 623 patients with complete data represented the study population. The mean age was 66.64 years (range 31-92) and 64.2% of the patients were men. The median of WBC count was 6.48×10~9 /L(range 2.34-27.10×10~9 /L).The mean time of follow up was 26.62 months (range 1-116) and MACEs occurred in 167 patients. The Cox proportional hazards model revealed that neutrophil count (RR=1.155, 95%CI:1.062-1.256, P=0.001) and eosinophil count (RR=3.810 , 95%CI:1.318-11.011, P=0.013) were risk factors for MACEs. Hemoglobin was a protective factor against MACEs. The logistic regression model revealed that neutrophil count ( OR=1.176, 95%CI:1.054-1.312, P=0.004 ) also was predictive of MACEs ; Neutrophil proportion(OR=1.056, 95%CI:1.003-1.111, P=0.038), lymphocyte count(OR=1.075, 95%CI:1.012-1.142, P=0.018), and monocyte count(OR=8.578, 95%CI:2.687-27.381, P<0.001) were predictive of stent use; Neutrophil proportion ( OR=1.060, 95%CI:1.007-1.115, P=0.026 ) , monocyte count ( OR=12.370, 95%CI:1.298-118.761, P=0.029), and platelet count (OR=1.004, 95%CI:1.000-1.008, P=0.038)were predictive of the presence of multivessel disease. Kaplan-Meier analysis of cumulative survival rate showed no significant statistical differences among three groups(P=0.522).Conclusions: In conclusion, the study did not demonstrate an association of peripheral total white blood cell with MACEs in coronary atherosclerotic heart disease. While Neutrophil count is predictive of MACEs in coronary atherosclerotic heart disease. Monocyte count and lymphocyte count are predictive of severity of coronary atherosclerosis.