| Leukocyte count in peripheral arterial disease: A simple, reliable, inexpensive approach to cardiovascular risk prediction. | |
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MedLine Citation:
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PMID: 19963213 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: An elevated leukocyte count is widely proven to predict cardiovascular risk in healthy subjects and coronary patients, but its prognostic role in peripheral arterial disease (PAD) has received scarce attention. OBJECTIVES: To assess the impact of leukocyte count on the incidence of major cardiovascular events in PAD, and verify whether it adds to the prognostic power of the ankle/brachial index (ABI). METHODS: The occurrence of myocardial infarction and stroke was prospectively assessed in 259 consecutive PAD patients. Receiver-operating characteristic analysis and the bootstrap approach were used to identify the best cut-offs to predict the outcome, and hazard ratios (HRs) and c-statistics to assess the ability to classify risk. RESULTS: During a median follow-up of 30.0 months, 28 patients had an event. Adjusted Cox analyses performed on total and differential leukocyte counts, showed that only total leukocyte count (TLC) and neutrophil count (NC), considered as continuous variables, were associated with increased cardiovascular risk (HR=1.35, p<0.01 and HR=1.31, p<0.02, respectively). Patients with ABI < or = 0.63 plus TLC>7.7 x10(9)/L or NC>4.6 x 10(9)/L had a higher risk of about 5-fold vs patients with ABI>0.63 plus TLC< or =7.7 x 10(9)/L (p<0.01) or NC < or = 4.6 x 10(9)/L (p<0.01). The c-statistic for ABI was 0.61, similar to those for TLC (0.63) and NC (0.66). However, it significantly increased to 0.70 and 0.69 for the models incorporating ABI and TLC or ABI and NC, respectively (p<0.05 for both vs ABI alone). CONCLUSIONS: TLC and NC, which are inexpensive and reliable tests, predict major cardiovascular events in PAD, and add to the prognostic power of ABI, currently the most powerful prognostic indicator in these patients. |
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Authors:
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Giuseppe Giugliano; Gregorio Brevetti; Simona Lanero; Vittorio Schiano; Eugenio Laurenzano; Massimo Chiariello |
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Publication Detail:
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Type: Journal Article Date: 2009-11-11 |
Journal Detail:
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Title: Atherosclerosis Volume: 210 ISSN: 1879-1484 ISO Abbreviation: Atherosclerosis Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-30 Completed Date: 2010-08-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0242543 Medline TA: Atherosclerosis Country: Ireland |
Other Details:
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Languages: eng Pagination: 288-93 Citation Subset: IM |
Copyright Information:
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Copyright 2009 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University of Naples Federico II, via Pansini 5, 80131 Naples, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Ankle Brachial Index Cardiovascular Diseases / diagnosis*, etiology Female Humans Leukocyte Count* Male Neutrophils / cytology Peripheral Vascular Diseases / blood*, complications Prognosis Proportional Hazards Models Prospective Studies |
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