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Patterns of leukocyte counts on admissions for acute heart failure - presentation and outcome - results from a community based registry.
MedLine Citation:
PMID:  19932515     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: To determine the correlation between differential white blood cell (WBC) count and characteristics and outcome of acute heart failure (AHF) syndromes.
BACKGROUND: Previous studies suggested that different white blood cell count patterns are related to outcome in patients with heart failure (HF) and other cardiovascular disorders.
METHODS: Data from all qualifying AHF admissions to a city hospital (n=340) was prospectively collected. Patients were followed from admission up to 6months post-discharge. The relationship between patients' demographics, clinical and laboratory characteristics and outcome were assessed in relation to WBC count and lymphocyte to WBC ratio (LWR).
RESULTS: WBC count >10,100×10 (9)/L (upper tertile) on admission was associated with higher admission blood pressure, lower oxygen saturation, higher heart rate and increased troponin, with no impact on either short-term worsening HF or long-term adverse outcome. Lower LWR was associated with higher BUN and troponin and lower hemoglobin, but not with a distinct clinical presentation. The lower LWR tertile (≤13%) was associated with a 60% increase in worsening HF risk and a substantially higher 1month (15% versus 2%) and 6months mortality (23% vs. 3%) for lowest versus highest quartile (p<0.0001).
CONCLUSIONS: While increased WBC count is associated with a more "vascular presentation" and certain severity markers, it is not related to worse patient outcome. Low LWR (≤13%) is predictive of worse outcome and higher mortality. It is also associated with certain laboratory abnormalities, but not related to a specific clinical profile.
Olga Milo-Cotter; G Michael Felker; Nir Uriel; Edo Kaluski; Christopher Edwards; Michele M Rund; Beth Davison Weatherley; Gad Cotter
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Publication Detail:
Type:  Journal Article     Date:  2009-11-22
Journal Detail:
Title:  International journal of cardiology     Volume:  148     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  17-22     Citation Subset:  IM    
Copyright Information:
Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.
Momentum Research Inc., Durham, North Carolina, USA.
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