| Relationship between low lymphocyte count and major cardiac events in patients with acute chest pain, a non-diagnostic electrocardiogram and normal troponin levels. | |
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MedLine Citation:
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PMID: 19230894 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Risk stratification of patients with acute chest pain, non-diagnostic electrocardiogram and normal troponin (ACPneg) remains a challenge, partly because no standardized set of biomarkers with prognostic ability has been identified in this population. Lymphopenia has been associated with atherosclerosis progression and adverse outcomes in cardiovascular diseases; although its prognostic value in ACPneg is unknown. We sought to determine the relationship between the lymphocyte count obtained in the Emergency Department (ED) and the risk of the long-term all-cause mortality or myocardial infarction (MI) in patients with ACPneg. METHODS: We analyzed 1030 consecutive patients admitted with ACPneg in our institution. Lymphocyte count was determined in the ED as a part of a routine diagnostic workup to rule out an acute coronary syndrome. Patients with inflammatory, infectious diseases, or active malignancy were excluded (final sample=975). The independent association between lymphocyte count and the composite endpoint (death/MI) was assessed by survival analysis for competing risk events (revascularization procedures). RESULTS: During a median follow-up of 36 months, 139 (14.3%) patients achieved the combined endpoint, with rates increasing monotonically across lymphocyte quartiles (6.2%, 10%, 20.6% and 24.1% for Q4, Q3, Q2 and Q1 (p<0.001), respectively). In a multivariable analysis, patients in lymphocytes' Q1 and Q2 as compared with those in Q4 had an increased risk for the combined endpoint: HR=2.45 (CI 95% 1.25-4.79, p=0.008) and HR=2.56 (CI 95% 1.30-5.07, p=0.007), respectively. CONCLUSION: In patients with ACPneg, low lymphocytes count was associated with an increased risk for developing the combined endpoint of death or MI. |
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Authors:
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Julio Núñez; Juan Sanchis; Vicent Bodí; Eduardo Núñez; Luis Mainar; Anne M Heatta; Oliver Husser; Gema Miñana; Pilar Merlos; Helene Darmofal; Mauricio Pellicer; Angel Llàcer |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-01-29 |
Journal Detail:
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Title: Atherosclerosis Volume: 206 ISSN: 1879-1484 ISO Abbreviation: Atherosclerosis Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-08-31 Completed Date: 2009-12-02 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: 251-7 Citation Subset: IM |
Affiliation:
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Servicio de Cardiología, Hospital Clínico Universitario, Universitat de Valencia, Avda. Blasco Ibáñez 17, Valencia, Spain. yulnunez@gmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Biological Markers Chest Pain / diagnosis, etiology* Diagnosis, Differential Electrocardiography* Emergency Service, Hospital Female Humans Lymphocyte Count* Male Middle Aged Myocardial Infarction / diagnosis*, mortality Troponin / blood* |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Troponin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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