The relative lymphocyte count on hospital admission is a risk factor for long-term mortality in patients with acute heart failure

Rudiger, Alain; Burckhardt, Oliver; Harpes, Paul; Müller, Stefan A.; Folláth, Ferenc

doi:10.1016/j.ajem.2005.10.010

Cited by 126 publications

(113 citation statements)

References 21 publications

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“…NLR was defined as a potential marker to determine inflammation in systemic disease (Walsh et al, 2005;Rudiger et al, 2006;Bucak et al, 2013;Ulu et al, 2013;Acmaz et al, 2014). Chronic inflammation in DM, like other chronic diseases, is well known (Schmidt MI, 1999).…”

Section: Discussionmentioning

confidence: 99%

Could the Platelet-to-Lymphocyte Ratio be a Novel Marker for Predicting Invasiveness of Cervical Pathologies?

Köse

Çelik²,

Köse³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Asian Pac J Cancer Prev, 16 (3), 923-926 IntroductionThe term preinvasive disease of the cervix (PCD) was first defined in 1947 (Pund, 1947). Despite the fact that epithelial changes give the appearance of invasive cancer on the cervix, lesions confined to the epithelium are to be noted in PCD. After PCD is defined, some studies have shown that if these lesions did not treat cervical dysplasia, it progresses to cervical cancer (Koss et al., 1963). Therefore, when the preinvasive lesions could be diagnosed before the stage of the invasive cervical cancer, this early detection allows easy treatment (Richart & Sciarra, 1968).Cervical cancer (CC) is still one of the most frequent malignancies in women worldwide (Siegel, Naishadham & Jemal, 2013). In CC, like the other cancers, the host response to malignant tumors comprises not only changes in the microenvironment, but also systemic alterations (Tavares-Murta et al., 2010). One of the important systemic alterations is inflammation. Inflammation is a nonspecific feature of cancer and plays an important role in various aspects of cancer involving cancer initiation, promotion, progression, metastasis and clinical features (Babu et al., 2012). Therefore, inflammatory markers were studied in various cancer types as indicators of invasion (Acmaz et al., 2014).The platelet-lymphocyte ratio (PLR) is an inflammatory marker and has been studied in uterine cancer and uterine cancer precursor lesions (Acmaz et al., 2014). The aim of

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Section: Discussionmentioning

confidence: 99%

Could the Platelet-to-Lymphocyte Ratio be a Novel Marker for Predicting Invasiveness of Cervical Pathologies?

Köse

Çelik²,

Köse³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…All previous studies in HHF used relative lymphocyte percentage instead of absolute counts. [8][9][10][11] Cutoffs for abnormally low values ranged from 13% 10,11 to 25%. 8 Patient follow-up Hazard ratios were calculated using Cox proportional hazard models.…”

Section: Discussionmentioning

confidence: 99%

“…Few small studies have suggested that lymphopenia may confer increased risk for mortality in stable outpatients [4][5][6][7] and patients with HHF. [8][9][10][11] Although low lymphocyte count is currently recognized in certain risk stratification scores for chronic heart failure, 12 contemporary HHF prognostication models lack inclusion of this potentially valuable parameter. 13,14 The Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan (EVEREST) trial [15][16][17] allows for systematic and in-depth analysis of the role of lymphocytes in a large cohort of patients with HHF with reduced ejection fraction (EF), well treated with evidence-based HF therapies, with close follow-up and monitoring.…”

Section: Clinical Perspective On P 758mentioning

confidence: 99%

Predictive Value of Low Relative Lymphocyte Count in Patients Hospitalized for Heart Failure With Reduced Ejection Fraction

Vaduganathan

Ambrosy

Greene

et al. 2012

Circ: Heart Failure

109

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Background-Low lymphocyte count has been shown to be an independent prognostic marker in heart failure (HF) in the outpatient setting. Limited data exist regarding whether relative lymphocyte count correlates with postdischarge outcomes in patients hospitalized for HF. Methods and Results-We performed a post hoc analysis of the Efficacy of Vasopressin Antagonism in Heart FailureOutcome Study with Tolvaptan (EVEREST) trial, which randomized 4133 patients hospitalized for worsening HF with an ejection fraction ≤40% within 48 hours of admission to tolvaptan or placebo for a median follow-up of 9.9 months. The primary end points of all-cause mortality and cardiovascular mortality or HF hospitalization were analyzed in patients with available baseline complete blood counts (n=3717). Lymphocyte percentage was analyzed as a continuous variable. Times to events were compared using log-rank tests and multivariable Cox regression models. Patients with low lymphocyte percentage tended to be older and had higher rates of comorbid disease (diabetes mellitus, atrial fibrillation, and renal insufficiency). Low lymphocyte counts were associated with wide QRS duration, high natriuretic peptides, and low ejection fraction, blood pressure, and serum sodium. These patients were less likely to receive evidence-based HF medications. After adjusting for 22 known clinical risk factors, a 10% decrease in lymphocytes was associated with an increased hazard of all-cause mortality (adjusted hazard ratio 1.31 [95% CI: 1.14-1.150], P<0.001) and cardiovascular mortality or HF hospitalization (adjusted hazard ratio 1.14 [95% CI: 1.04-1.25], P=0.007) in the first 100 days postdischarge. Lymphopenia during hospitalization normalizes in majority of patients in the early postdischarge period. Conclusions-Low relative lymphocyte count during hospitalization for HF is an independent predictor of poor outcomes in the early postdischarge period, beyond traditional prognostic indicators. (Circ Heart Fail. 2012;5:750-758.)

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“…[15][16][17][18][19] A low proportion of lymphocytes has been associated with increased mortality in HF patients. 34 The neutrophiles is the cell population, which influence the level and variation of leukocyte count most. On the other hand, it has been shown that lymphocytes and monocytes is a source of proinflammatory cytokines in HF patients and seem to contribute to the systemic inflammation in these patients.…”

Section: Discussionmentioning

confidence: 99%

Leukocyte Count and Incidence of Hospitalizations Due to Heart Failure

Engström

Melander

Hedblad

2009

Circ: Heart Failure

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Background-Leukocyte concentration in blood is a classical marker of systemic inflammation. Whether high leukocyte counts are associated with incidence of heart failure (HF) is unknown. This population-based study explored whether the leukocyte concentrations were associated with incidence of hospitalizations due to HF. Methods and results-Leukocyte counts were measured in 16 940 men from the general population (mean age 44 years) without history of myocardial infarction or stroke. Incidence of hospitalizations due to HF (primary diagnosis) was monitored over 23 years of follow-up, in relation to quartiles of leukocytes. Subjects with myocardial infarction during follow-up were censored in the main analysis. During the follow-up, 436 men were hospitalized due to HF. Incidence of HF hospitalizations was increased in men with high leukocyte counts. After adjustments for confounding factors, the adjusted hazards ratio (HR, 95% CI) for HF hospitalization was 1.00 (reference), 1.26 (0.93 to 1.7), 1.24 (0.91 to 1.7), and 1.73 (1.3 to 2.3), respectively, for men with leukocytes in the 1st, 2nd, 3rd, and 4th (highest) quartiles (trend, PϽ0.001). This relationship was consistent in smokers and nonsmokers and in men with and without hypertension, respectively. Conclusion-High leukocyte counts in middle-aged men were associated with increased long-term incidence of HF hospitalizations. (Circ Heart Fail. 2009;2:217-222.)

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The relative lymphocyte count on hospital admission is a risk factor for long-term mortality in patients with acute heart failure

Cited by 126 publications

References 21 publications

Could the Platelet-to-Lymphocyte Ratio be a Novel Marker for Predicting Invasiveness of Cervical Pathologies?

Could the Platelet-to-Lymphocyte Ratio be a Novel Marker for Predicting Invasiveness of Cervical Pathologies?

Predictive Value of Low Relative Lymphocyte Count in Patients Hospitalized for Heart Failure With Reduced Ejection Fraction

Leukocyte Count and Incidence of Hospitalizations Due to Heart Failure

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