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Elevated leukocyte count and adverse hospital events in patients with acute coronary syndromes: findings from the Global Registry of Acute Coronary Events (GRACE)
Quantitative Health Sciences Publications and Presentations
  • Mark I. Furman, University of Massachusetts Medical School
  • Joel M. Gore, University of Massachusetts Medical School
  • Frederick A. Anderson, University of Massachusetts Medical School
  • Andrzej Budaj, Grochowski Hospital
  • Shaun G. Goodman, University of Toronto
  • Ávaro Avezum, CTI-A Hospital Albert Einstein
  • José López-Sendón, Hospital Universitario Gregorio Marañon
  • Werner Klein
  • Debabrata Mukherjee, University of Michigan
  • Kim A. Eagle, University of Michigan
  • Omar H. Dabbous, University of Massachusetts Medical School
  • Robert J. Goldberg, University of Massachusetts Medical School
UMMS Affiliation
Department of Medicine, Division of Cardiovascular Medicine; Department of Surgery
Date
1-24-2004
Document Type
Article
Medical Subject Headings
Adult; Aged; Analysis of Variance; Angina, Unstable; Arrhythmias, Cardiac; Female; Heart Failure; *Hospital Mortality; Humans; Inflammation; *Leukocyte Count; Male; Middle Aged; Myocardial Infarction; Predictive Value of Tests; Syndrome
Abstract
OBJECTIVE: To examine the association between elevated leukocyte count and hospital mortality and heart failure in patients enrolled in the multinational, observational Global Registry of Acute Coronary Events (GRACE). BACKGROUND: Elevated leukocyte count is associated with adverse hospital outcomes in patients presenting with acute myocardial infarction (AMI). The association of this prognostic factor with hospital mortality and heart failure in patients with other acute coronary syndromes (ACS) is unclear. METHODS: We examined the association between admission leukocyte count and hospital mortality and heart failure in 8269 patients presenting with an ACS. This association was examined separately in patients with ST-segment elevation AMI, non-ST-segment elevation AMI, and unstable angina. Leukocyte count was divided into 4 mutually exclusive groups (Q): Q1 <6000, Q2 = 6000-9999, Q3 = 10,000-11,999, Q4 >12,000. Multiple logistic regression analysis was performed to examine the association between elevated leukocyte count and hospital events while accounting for the simultaneous effect of several potentially confounding variables. RESULTS: Increasing leukocyte count was significantly associated with hospital death (adjusted odds ratio [OR] 2.8, 95% CI 2.1-3.6 for Q4 compared to Q2 [normal range]) and heart failure (OR 2.7, 95% CI 2.2-3.4) for patients presenting with ACS. This association was seen in patients with ST-segment elevation AMI (OR for hospital death 3.2, 95% CI 2.1-4.7; OR for heart failure 2.4, 95% CI 1.8-3.3), non-ST-segment elevation AMI (OR for hospital death 1.9, 95% CI 1.2-3.0; OR for heart failure 1.7, 95% CI 1.1-2.5), or unstable angina (OR for hospital death 2.8, 95% CI 1.4-5.5; OR for heart failure 2.0, 95% CI 0.9-4.4). CONCLUSION: In men and women of all ages with the spectrum of ACS, initial leukocyte count is an independent predictor of hospital death and the development of heart failure.
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Citation: Am Heart J. 2004 Jan;147(1):42-8.
Related Resources
Link to Article in PubMed
Citation Information
Mark I. Furman, Joel M. Gore, Frederick A. Anderson, Andrzej Budaj, et al.. "Elevated leukocyte count and adverse hospital events in patients with acute coronary syndromes: findings from the Global Registry of Acute Coronary Events (GRACE)" Vol. 147 Iss. 1 (2004) ISSN: 0002-8703 (Linking)
Available at: http://works.bepress.com/robert_goldberg/75/