Monocytes may be favorable biomarker and predictor of long-term outcome in patients with chronic heart failure

Abstract

Although some studies found that an increased monocyte count is a predictive, short-term marker of unfavorable outcomes for patients with acute heart failure (HF), others have reported that monocytosis predicts prolonged survival.The current follow-up study aimed to identify different monocyte count patterns and their prognostic association with HF outcomes.Baseline blood samples for complete blood counts, differential counts, renal function tests, and lipid profiles of 303 chronic HF patients (average NYHA classification 2.8) were prospectively obtained to evaluate whether there is an association between monocyte count and clinical outcomes.Mean follow-up was 11.3 years (range 1 month to 16 years) and 111 (36.6%) patients died during follow-up. Mean monocyte count was 10.6 ± 5.5 and mean left ventricular ejection fraction (LVEF) was 36%. Patients with low monocyte counts (≤6%) had significantly lower survival rates than did those with monocyte counts 6.1% to 14%, or >14% (14.3% vs 70.2% vs. 88%, P < .001). Poorest survival was predicted for patients with NYHA class 3 to 4 and monocyte counts ≤6. Regression analysis showed that monocyte levels, NYHA class, and LVEF values were predictors of mortality, in decreasing importance.The total monocyte count was found to be an important prognostic factor that was inversely associated with predicted long-term mortality among patients with chronic HF. A low total monocyte count was strongly correlated with NYHA class and B-type natriuretic peptide levels, but no correlation was found with LVEF and oxidized low-density lipoproteins. It emerged as an independent risk factor for mortality in patients with chronic HF.

Hyperactivation of monocytes and macrophages in MCI patients contributes to the progression of Alzheimer's disease

“…We found that the proportions of non-classical monocytes increased through the spectrum of AD from SMC to AD, while the intermediate monocyte subset increased only in MCI and AD patients at the expense of classical monocytes. The intermediate and non-classical monocytes seem to be more inflammatory [ 115 – 117 ] as has been shown also in other inflammatory diseases (e.g., heart failure [ 109 , 118 , 119 ]), as well as in aging per se [ 120 – 124 ], however this was not the case in studies where no change at the basal level was found [ 125 ]. This increased propensity to higher inflammatory phenotype has been attributed to the expression of CD16 by both intermediate and non-classical monocytes, which were suggested to resemble the senescent monocyte population with increased inflammatory potential due to their SASP state [ 122 – 124 ].…”

Platelet Activity and Its Correlation with Inflammation and Cell Count Readings in Chronic Heart Failure Patients with Reduced Ejection Fraction

“…Monocytes [ 8 ] and other leucocytes play important roles in chronic inflammatory processes [ 38 ]. Low total monocyte counts have been shown in several studies, which noted an association with the increased risk for mortality in HF patients [ 39 , 40 , 41 ]. However, more studies have supported an association of increasing monocyte count with worse outcomes [ 42 , 43 ].…”

“…A reason why different studies present conflicting results may be because of different subsets of monocytes being predominant in CHF groups [ 39 ]. One work showed that Mon 3 gradually increased in NYHA groups ( p = 0.0002) and negatively correlated with LVEF (r = −0.628, p = 0.022) [ 44 ].…”

“…These correlations can be assumed as a relationship between inflammation and platelet production. In Charach’s work [ 39 ], it was stated that Hs-CRP did not differ in groups according to monocyte distribution in CHF patients. However, we found a moderate correlation between the monocyte count and CRP.…”

Association between gestational age at delivery and lymphocyte-monocyte ratio in the routine second trimester complete blood cell count

“…LMR has been proposed as a surrogate marker for inflammation and has prognostic value too [18][19][20]. Further, an abnormal monocyte or lymphocyte count has been shown to have an adverse effect on the prognosis of various diseases [21,22]. In the field of obstetrics, there have been several studies regarding the association between CBC parameters and obstetric complications in addition to the ability of CBC to predict preterm birth.…”