Abstract 4072: Granulocyte Counts and not Monocyte or Lymphocyte Counts are Associated with Increased Risk of Coronary Heart Disease, Cardiovascular Disease and Total Mortality in 16,108 apparently Healthy Men and Women in The EPIC-Norfolk Prospective Population Study
Background: Increased total leukocyte count is associated with increased risk for coronary heart disease (CHD). There is paucity of data on the differential leucocyte count and its relationship with the incidence of CHD, cardiovascular disease (CVD) and total mortality. We examined the relationship between granulocyte, lymphocyte and monocyte counts and risk of CHD, CVD and total mortality in men and women.
Research Design and Methods: This prospective study comprised 7,073 men and 9,035 women who were 45 to 79 years of age and were residents of Norfolk. United Kingdom.
Results: During an average of 8 years of follow-up we identified 857 incident CHD events, 2581 CVD incident events and 1167 people who died from any cause. Increased total leukocyte count was associated with increased risk for all three endpoints: CHD, CVD and total mortality. The highest quartile of granulocyte count was also associated with increased risk when compared to lowest quartile , for all three outcomes CHD (men HR 1.71 95% CI 1.31–2.23; women HR 1.21 95% CI 1.03–1.43; pooled HR1.47 1.21–1.78), CVD (men HR 1.47 95% CI 1.25–1.73; women HR 1.21 95% CI 1.03–1.43; pooled HR1.34 95% 1.20–1.50), and total mortality (men HR 1.55 95% CI 1.23–1.95; women HR 1.20 95% CI 0.92–1.56; pooled HR1.43 95%CI 1.21–1.70). Lymphocyte count or monocyte counts were not significantly associated with increased risk of CHD, CVD or total mortality. Among men, increased lymphocyte and monocyte countes were unexpectedly associated with decreased risk for all cause mortality (HR 0.78 (95% CI 0.63– 0.98) for lymphocytes and HR 0.76 (95% CI 0.60– 0.96) for monocyte count, for highest versus lowest quartile.
Conclusions: In conclusion we found that the higher risk for CHD, CVD and total mortality associated with increased total leukocyte count seems to be accounted for by the increased granulocyte count. We also noted intriguing sex differences which need to be considered when assessing the association between inflammatory markers and risk of CHD.