Basophil Blood Cell Count Is Associated With Enhanced Factor II Plasma Coagulant Activity and Increased Risk of Mortality in Patients With Stable Coronary Artery Disease: Not Only Neutrophils as Prognostic Marker in Ischemic Heart Disease

Abstract

Background White blood cell count, which is inexpensive and widely available in clinical practice, has been proposed to provide prognostic information in coronary artery disease (CAD). Elevated levels of white blood cell subtypes may play different roles in atherothrombosis and predict cardiovascular outcomes. Methods and Results The association between white blood cell counts and mortality was evaluated in 823 subjects with angiographically demonstrated and clinically stable CAD in an observational–longitudinal study. The correlation among white blood cell counts and factor II plasma coagulant activity was analyzed in 750 subjects (554 CAD and 196 CAD‐free) not taking anticoagulant drugs. Subjects with overt leukocytosis or leukopenia were excluded. In the longitudinal study after a median follow‐up of 61 months, 160 (19.4%) subjects died, 107 (13.0%) of whom from cardiovascular causes. High levels of neutrophils, monocytes, eosinophils, and basophils were associated with an increased mortality rate. In multiadjusted Cox regression models, only neutrophils and basophils remained predictors of total and cardiovascular mortality. The associations remained significant after adjustment for traditional cardiovascular risk factors and by including D‐dimer and the chemokine CXCL12 in the regression models. Neutrophils and basophils were also significant predictors of factor II plasma coagulant activity variability after adjustment for blood cell counts, age, sex, inflammatory markers, CAD diagnosis, and prothrombin G20210A polymorphism. Factor II plasma coagulant activity was similarly increased in subjects with high neutrophil and basophil counts and in carriers of the prothrombin 20210A allele. Conclusions Both high neutrophil and basophil blood counts may predict mortality in patients with clinically stable CAD and are associated with enhanced factor II plasma coagulant activity, thereby suggesting underlying prothrombotic mechanisms.

Sex Difference in the Association Between Neutrophil to Lymphocyte Ratio and Severity of Coronary Artery Disease

“…Weight, height, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured. Body mass index (BMI) was calculated as weight (kg)/height (m) 2 . Serum fasting total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), and glucose were measured using a Siemens ADVIA 2400 Chemistry analyzer (Siemens Healthcare Diagnostics, Tarrytown, NY, USA).…”

“…In this context, several inflammatory biomarkers were not only directly involved in the atherosclerotic lesions but also could predict the risk and mortality from CAD. 2-6 Increased blood neutrophil count and neutrophil to lymphocyte ratio (NLR) have been reported be related with the presence, severity, and outcome of coronary artery stenosis. 7-9…”

“…In this context, several inflammatory biomarkers were not only directly involved in the atherosclerotic lesions but also could predict the risk and mortality from CAD. [2][3][4][5][6] Increased blood neutrophil count and neutrophil to lymphocyte ratio (NLR) have been reported be related with the presence, severity, and outcome of coronary artery stenosis. [7][8][9] There are significant differences in neutrophil count and NLR between males and females, and between premenopause and post-menopause stages in females.…”

Comprehensive Analysis of Differentially Expressed lncRNAs in the Perivascular Adipose Tissue of Patients with Coronary Heart Disease

“…Compared with mast cells, basophils are present in lower numbers in the body, and their relationship with cardiovascular disease is not clear. Pizzolo et al [49] evaluated the association between white blood cell count and mortality in 823 patients with contrast-proven and clinically stable CHD; they identified that high levels of neutrophils and basophils Blood counts can predict mortality in patients with clinically stable CHD, and that these mechanisms may be related to throm- botic. Therefore, the specific mechanism of action of basophils in cardiovascular diseases is worthy of further study and exploration.…”

The role of blood CXCL12 level in prognosis of coronary artery disease: A meta-analysis

“…Thereafter, several studies supported the positive correlation between higher blood CXCL12 levels and increased risk of future (both short and long terms) adverse clinical outcomes in patients with CAD ( 12 – 14 ). However, negative or even opposite results were also reported, which found no significant correlation between blood CXCL12 levels and CAD prognosis ( 15 ), or even higher serum CXCL12 levels predicting lower future cardiovascular events in patients with CAD ( 16 ). Thus, the association between blood CXCL12 levels and future major adverse cardiovascular events (MACEs) in patients with CAD seems to be controversial.…”