Document Detail

The relative lymphocyte count predicts death in patients receiving implantable cardioverter defibrillators.
MedLine Citation:
PMID:  12418738     Owner:  NLM     Status:  MEDLINE    
Although the survival benefit conveyed by the automatic defibrillator has been well established for several subsets of patients, some patients who receive the device still die early. The relative lymphocyte count (%L), a portion of the white blood cell count differential, which is decreased in states of excess systemic stress, has prognostic value in patients with coronary artery disease and advanced heart failure. This study assessed the association of %L with survival in patients receiving automatic defibrillators. A total of 136 consecutive patients (81% men; mean age 64 +/- 12 years) who were using automatic defibrillators were followed for 29.6 months. The mean ejection fraction was 0.36 +/- 0.17, the mean %L was 22.7 +/- 8%, and 55 (40%) patients had decreased %L (< 20.3%). There were 20 deaths, for a 4-year survival of 71.5%. The association of %L with time to death was assessed by Cox proportional hazards analysis. Ejection fraction (P = 0.005), %L (P = 0.01), and diagnosis (P = 0.03) were independently associated with time to death on multivariate analysis. One-year and 4-year survival rates were 93% and 54%, respectively, for the 55 patients with abnormal %L, compared with 99% and 84%, respectively, for the 81 with normal %L (P = 0.03). This suggests that the %L is a readily accessible prognostic marker in patients using automatic defibrillators. This association is independent of age, sex, diagnosis, and ejection fraction.
Steve R Ommen; Stephen C Hammill; Raymond J Gibbons
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  25     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-11-06     Completed Date:  2003-02-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1424-8     Citation Subset:  IM    
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MeSH Terms
Defibrillators, Implantable*
Heart Diseases / blood,  mortality*
Lymphocyte Count*
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Retrospective Studies
Risk Factors
Survival Analysis
Survival Rate

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

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