Abstract 13224: Which White Cell Subtypes Predict the Presence of Coronary Artery Disease in High Risk Patients Over 55 Years Old?
Introduction: Inflammation has an important role in initiation and progression of coronary artery disease (CAD). Different white cell count (WCC) subtypes may reflect different mechanisms of this complex disease, and may be valuable clinically in risk stratification and detection of patients with CAD. Studies on the correlation between WCC subtypes and CAD have yielded conflicting results.
Hypothesis: We hypothesized that WCC subtypes are associated with the presence of CAD in high-risk patients over 55 years old.
Methods: We analyzed 622 patients over the age of 55 from the BRAVEHEART and MINACS cohort who were referred for coronary angiogram at our institution. Univariate and multivariate logistic regression models were used to compare different WCC subtypes as predictors of presence of CAD, defined as ≥50% stenosis of 1 or more coronary arteries. We adjusted for age, sex and conventional cardiac risk factors.
Results: On univariate analysis, patients with CAD had significantly more CVD risk factors compared to control patients. Markers associated with CAD were lower lymphocytes (tertile 2 OR 0.61, 95% CI 0.39-0.98, p=0.040, tertile 3 OR 0.70, 95% CI 0.44-1.12, p=0.139), and higher monocytes (tertile 3 OR 2.51, 95% CI 1.45-4.34, p=0.001), neutrophil-lymphocyte ratio (NLR) (OR 1.70, 95% CI 1.07-2.68, p=0.024), and monocyte-lymphocyte ratio (MLR) (tertile 3 OR 2.62, 95% CI 1.61-4.26, p<0.001). After adjustment for CVD risk factors, lower lymphocytes (tertile 2 OR 0.40, 95% CI 0.22-0.73, p=0.003, tertile 3 OR 0.50, 95% CI 0.27-0.93, p=0.028), and higher monocytes (tertile 3 OR 2.38, 95% CI 1.23-4.61, p=0.010), NLR (tertile 3 OR 1.91, 95% CI 1.08-3.38, p=0.025), and MLR (tertile 3 OR 2.26, 95% CI 1.23-4.14, p=0.009) were associated with CAD.
Conclusions: In high-risk patients over 55 years old, lower lymphocytes, and higher monocytes, NLR and MLR were associated with angiographically determined CAD independent of other risk factors. Monocytes and MLR were the strongest correlates of CAD in high-risk patients over 55. Whether these can be used as biomarkers of CAD in high risk patients warrants further study.
Author Disclosures: I. Trakarnwijitr: None. B.V. Li: None. H. Adams: None. J. Layland: None. J. Garlick: None. A.M. Wilson: None.
- © 2015 by American Heart Association, Inc.