Abstract 10633: The Complete Blood Count Risk Score and Its Components Including the Red Cell Distribution Width are Associated With Mortality in the JUPITER Trial
Background: Previously, we showed that sex-specific complete blood count (CBC) risk scores (integrating each CBC component plus age) are strongly associated with risk of all-cause mortality in general medical patients at Intermountain Healthcare. This predictive ability of the CBC score was validated in a similar but independent population at Intermountain. The objective of this study was to prospectively validate the CBC risk score in an independent, well-studied international primary risk population of lower-risk individuals initially free from cardiovascular (CV) disease.
Methods: The previously-derived CBC risk score was evaluated for association with all-cause mortality among CV disease-free females (n=6,568) and males (n=10,629) enrolled in the Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) Trial. The associations of the CBC score with CV mortality and with major CV disease were also tested.
Results: The CBC risk score predicted all-cause mortality, with univariable hazard ratio (HR)=4.83 (95% CI=3.70, 6.31) for the third CBC score tertile and HR=2.31 (CI=1.75, 3.05) for the second tertile compared to the first tertile (p-trend<0.001). The CBC score retained significance after multivariable adjustment, including for age (one of the risk score’s components): with HR=1.97 (CI=1.46, 2.67) and 1.51 (CI=1.13, 2.00) for tertiles 3 and 2 vs. 1, respectively (p-trend <0.001). CV mortality (p-trend=0.025) and the primary JUPITER CV disease endpoint (p-trend=0.015) were also predicted by the CBC score. C-statistics for all-cause mortality were c=0.729 among all participants and c=0.722 and c=0.750 for females and males, respectively.
Conclusions: The CBC risk score was strongly associated with all-cause mortality risk among JUPITER Trial participants, had good discrimination, and predicted CV-specific outcomes. While this study did not examine clinical applications of the CBC score, identification of apparently healthy individuals at increased risk of mortality may be useful in emphasizing optimal application of standard prevention therapies.
- © 2013 by American Heart Association, Inc.