Document Detail


Elevated leukocyte count and adverse hospital events in patients with acute coronary syndromes: findings from the Global Registry of Acute Coronary Events (GRACE).
MedLine Citation:
PMID:  14691417     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the association between elevated leukocyte count and hospital mortality and heart failure in patients enrolled in the multinational, observational Global Registry of Acute Coronary Events (GRACE). BACKGROUND: Elevated leukocyte count is associated with adverse hospital outcomes in patients presenting with acute myocardial infarction (AMI). The association of this prognostic factor with hospital mortality and heart failure in patients with other acute coronary syndromes (ACS) is unclear. METHODS: We examined the association between admission leukocyte count and hospital mortality and heart failure in 8269 patients presenting with an ACS. This association was examined separately in patients with ST-segment elevation AMI, non-ST-segment elevation AMI, and unstable angina. Leukocyte count was divided into 4 mutually exclusive groups (Q): Q1 <6000, Q2 = 6000-9999, Q3 = 10,000-11,999, Q4 >12,000. Multiple logistic regression analysis was performed to examine the association between elevated leukocyte count and hospital events while accounting for the simultaneous effect of several potentially confounding variables. RESULTS: Increasing leukocyte count was significantly associated with hospital death (adjusted odds ratio [OR] 2.8, 95% CI 2.1-3.6 for Q4 compared to Q2 [normal range]) and heart failure (OR 2.7, 95% CI 2.2-3.4) for patients presenting with ACS. This association was seen in patients with ST-segment elevation AMI (OR for hospital death 3.2, 95% CI 2.1-4.7; OR for heart failure 2.4, 95% CI 1.8-3.3), non-ST-segment elevation AMI (OR for hospital death 1.9, 95% CI 1.2-3.0; OR for heart failure 1.7, 95% CI 1.1-2.5), or unstable angina (OR for hospital death 2.8, 95% CI 1.4-5.5; OR for heart failure 2.0, 95% CI 0.9-4.4). CONCLUSION: In men and women of all ages with the spectrum of ACS, initial leukocyte count is an independent predictor of hospital death and the development of heart failure.
Authors:
Mark I Furman; Joel M Gore; Fredrick A Anderson; Andrzej Budaj; Shaun G Goodman; Avaro Avezum; José López-Sendón; Werner Klein; Debabrata Mukherjee; Kim A Eagle; Omar H Dabbous; Robert J Goldberg;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  147     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2003-12-23     Completed Date:  2004-01-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  42-8     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, Mass 01655, USA. mark.furman@umassmed.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analysis of Variance
Angina, Unstable / blood,  mortality*
Arrhythmias, Cardiac / blood,  mortality*
Female
Heart Failure / blood,  etiology*
Hospital Mortality*
Humans
Inflammation / blood,  complications
Leukocyte Count*
Male
Middle Aged
Myocardial Infarction / blood,  mortality*
Predictive Value of Tests
Syndrome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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