Absolute lymphocyte count as a predictor of mortality and readmission in heart failure hospitalization

Majmundar, Monil; Kansara, Tikal; Park, Hansang; Ibarra, Gabriel Lara; Lenik, Joanna M.; Shah, Prasun; Kumar, Ashish; Doshi, Rajkumar; Zala, Harshvardhan; Chaudhari, Shobhana; Kalra, Ankur

doi:10.1016/j.ijcha.2022.100981

Cited by 24 publications

(20 citation statements)

References 34 publications

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“…Renal hypoperfusion and excessive diuretic use result in increased BUN levels, which are linked to lymphopenia [31]. The activation of the sympathetic system and inflammatory cytokines increases endogenous cortisol levels, which may contribute to lymphocytopenia, neutrophilia, and hyperglycemia [32,33]. In this study group, hyperosmolality was mainly explained by hypernatremia, increased BUN levels, and hyperglycaemia.…”

Section: Discussionmentioning

confidence: 69%

Systemic Immune-Inflammation Index Predicted Presence and Severity of Coronary Artery Disease

Eyyupkoca¹,

Kocak²,

Yıldırım³

et al. 2022

Ann Med Res

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Objective: We aimed to investigate whether systemic immune-inflammation index, an easily available inflammatory and immune response marker, is associated with SYNTAX score (SS) in patients admitted with suspected CAD who underwent coronary angiography (CAG). Materials and Methods: Evaluated retrospectively were 456 patients who CAG from the cardiology outpatient clinic between January 2020 and January 2022. The SII was calculated by the formula neutrophil × platelet / lymphocyte. SS scores were divided into 3 groups as <22 (lowest), 22-32 (intermediate), and ≥32 (highest). Those with an SS of 0 were taken as the control group. Results: Median were higher in CAD group compared to control group SII (631.0 vs 381.5, p< 0.001), and a positive correlation was found between SS and SII (r= 0.578, p<0.001) levels. Median SII levels were found to be higher as SS severity increased (p< 0.05 for each SS group). The cut-off value of SII in predicting the presence of CAD was >594.2, with 56.7% sensitivity and 91.1% specificity (AUC ± SE = 0.807 ± 0.020, p < 0.001). In addition, it was found that SII predicted lowest SS group compared to the control group (OR = 1.06; p < 0.001), intermediate SS compared to lowest SS (OR = 1.03; p < 0.001), and highest SS compared to intermediate SS (OR = 1.04; p < 0.001). Conclusion: SII has the potential to be a screening marker for presence and severity of CAD before CAG. This study demonstrates that SII is independently associated with coronary atherosclerosis burden.

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Section: Discussionmentioning

confidence: 69%

Systemic Immune-Inflammation Index Predicted Presence and Severity of Coronary Artery Disease

Eyyupkoca¹,

Kocak²,

Yıldırım³

et al. 2022

Ann Med Res

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“…Лімфопенія (< 1500/мм 3 ) була пов'язана з вищою на 82 % смертністю у пацієнтів із серцевою недостатністю, незалежно від ФВ ЛШ [21]. Лімфопенія була важливим предиктором повторної госпіталізації від усіх причин у пацієнтів із СНзнФВ [21].…”

Section: рисунок 1 загальна смертність досліджуваної групи хворих за ...unclassified

Laboratory Predictors of Mortality in Patients with Heart Failure and Reduced Left Ventricular Ejection Fraction

Kucheriava,

Mankovskyi

2023

ujcvs

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Introduction. Heart failure (HF) is a growing epidemic with high morbidity and mortality rates. In general, mortality in patients with HF is 10.4% after 30 days from admission, 22% after 1 year, and 42.3% after 5 years, despite the introduction of new evidence-based drug therapy and advance in surgical interventions. There is a range of predictors/ factors that need to be addressed to reduce the risk of mortality and to assess prognosis in patients with heart failure and reduced left ventricular ejection fraction. The aim. To determine the laboratory factors predicting 2-year mortality in patients with coronary artery disease and heart failure and reduced left ventricular ejection fraction after percutaneous coronary intervention (PCI) by analysis of basic patient data. Materials and methods. This one-center analysis, conducted at the Ukrainian Children’s Cardiac Center, Clinic for Adults, included 178 patients who had chronic stable coronary artery disease with heart failure and reduced left ventricular ejection fraction, who underwent PCI in the period between January 2020 and January 2022. The endpoint of our study was all-cause mortality. The studied group of patients was divided into two subgroups: S (“survival”) with patients who survived during the observation period after PCI, and D (“death”) including patients who died before the end of this observation period after the PCI. A p-value of less than 0.05 was considered statistically significant. Results. The mean length of hospital stay was 3 (1-5) days. Total bilirubin, total cholesterol, sodium, N-terminal pro B-type natriuretic peptide (NT-proBNP) level, hemoglobin, albumin and lymphocytes were significantly different in the two subgroups. In the multivariate model, the strongest independent predictors of patient mortality were: elevated NT-proBNP (adjusted hazard ratio [HR] for one standard deviation 1.44, 95% confidence interval [CI] 1.32 to 1.57, p<0.0001), low albumin (HR 1.64, 95% CI 1.10 to 2.23, p=0.008), hyponatremia (HR 1.69, 95% CI 1.16 to 2.22, p<0.001), lymphopenia (HR 1.54, 95% CI 1.10 to 2.20, р<0.001, decreased hemoglobin level (HR 1.25, 95% CI 1.10 to 1.40, p<0.001) and low cholesterol (HR 1.59, 95% CI 1.17 to 2.01, p<0.001). Conclusion. In a population of patients with chronic stable coronary artery disease after myocardial revascularization with PCI, a decrease in the level of albumin, cholesterol, sodium, lymphocytes, hemoglobin, as well as an increase in the level of NT-proBNP were prognostic and statistically significant predictors of unfavorable prognosis in the form of all-cause mortality during 2 years of observation.

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“…The relationship between heart failure and haemogram varies, and studies have been conducted on the prognosis of heart failure in the context of haematological changes. 1 , 2 , 3 If these relationships are clarified, they may be useful in understanding the pathophysiology of heart failure and may have great clinical significance.…”

Section: Introductionmentioning

confidence: 99%

“…The haemogram shows the number of red blood cells (RBCs), white blood cells (WBCs), and platelets (Plts); size and shape of these blood cells; and percentage of WBC, which are frequently examined in clinical practice, including in cardiovascular medicine. The relationship between heart failure and haemogram varies, and studies have been conducted on the prognosis of heart failure in the context of haematological changes 1–3 . If these relationships are clarified, they may be useful in understanding the pathophysiology of heart failure and may have great clinical significance.…”

Section: Introductionmentioning

confidence: 99%

Relationship between haemodynamic indicators and haemogram in patients with heart failure

Ogawa

Nagoshi

et al. 2022

ESC Heart Failure

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Aims Pulmonary congestion, reduced cardiac output, neurohumoral factor activation, and decreased renal function associated with decreased cardiac function may have various effects on haemograms. The relationship between these factors and haemograms in patients with heart failure has not been sufficiently investigated. Recently, it was suggested that the lungs are an important site for platelet (Plt) biosynthesis and that it is necessary to study the relationship between pulmonary congestion and Plt count in heart failure in detail. In this study, we examined the relationship between various haemodynamic indicators and haemograms in detail using statistical analyses. Methods and results A total of 345 patients who underwent cardiac catheterization for the evaluation of cardiac function between 1 January 2015 and 31 December 2020 were included in the study. Haemodynamic indices, including left ventricular end‐diastolic pressure (LVEDP) and cardiac index (CI), were measured. Plasma noradrenaline (Nor) concentration, estimated glomerular filtration rate (eGFR), white blood cell (WBC) count, haemoglobin (Hb) level, and Plt count were measured using blood samples collected at the same time. Structural equation modelling (SEM) was used to examine the relationship between LVEDP, CI, plasma Nor concentration, eGFR, WBC count, Hb level, and Plt count. Bayesian inference using SEM was performed for Plt count. A total of 345 patients (mean age: 66.0 ± 13.2 years) were included in this study, and 251 (73%) patients were men. After simple and multiple regression analyses, path diagrams were drawn and analysed using SEM. LVEDP showed a significant negative relationship with Plt count (standardized estimate: −0.129, P = 0.015), and CI showed a significant negative relationship with Hb level (standardized estimate: −0.263, P < 0.001). Plasma Nor concentration showed a significant positive relationship with WBC count (standardized estimate: 0.165, P = 0.003) and Plt count (standardized estimate: 0.198, P < 0.001). The eGFR had a significant positive relationship with Hb level (standardized estimate: 0.274, P < 0.001). Bayesian inference using SEM revealed no relationship between LVEDP and Hb level or WBC count but a significant negative relationship between LVEDP and Plt count. Conclusions LVEDP, CI, plasma Nor concentration, and eGFR were related to WBC count, Hb level, and Plt count in patients with heart failure. There was a strong relationship between elevated LVEDP and decreased Plt count, suggesting that pressure overload on the lungs may interfere with the function of the lung as a site of Plt biosynthesis.

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Absolute lymphocyte count as a predictor of mortality and readmission in heart failure hospitalization

Cited by 24 publications

References 34 publications

Systemic Immune-Inflammation Index Predicted Presence and Severity of Coronary Artery Disease

Systemic Immune-Inflammation Index Predicted Presence and Severity of Coronary Artery Disease

Laboratory Predictors of Mortality in Patients with Heart Failure and Reduced Left Ventricular Ejection Fraction

Relationship between haemodynamic indicators and haemogram in patients with heart failure

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