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Updated: Aug 16, 2026
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Relation of leukocytosis to C-reactive protein and interleukin-6 among patients undergoing percutaneous coronary
Prospero B Gogo1, David J Schneider, Edward F Terrien
1Division of Cardiology, University of Vermont College of Medicine, Burlington, Vermont, USA. prospero.gogo@vtmednet.org
Insights
Elevated white blood cell (WBC) count and C-reactive protein (CRP) indicate inflammation. In patients undergoing percutaneous coronary intervention (PCI), elevated WBC counts are linked to inflammation, especially in those with negative troponin I.
Area of Science:
- Cardiology
- Biomarkers
- Inflammation
Background:
- Elevated white blood cell (WBC) count and C-reactive protein (CRP) are linked to adverse cardiac events.
- Systemic inflammation plays a role in cardiovascular disease progression.
Purpose of the Study:
- To characterize the relationship between WBC count and CRP in patients undergoing percutaneous coronary intervention (PCI).
- To investigate the association between pre-PCI WBC count and inflammatory markers like CRP and interleukin-6.
Main Methods:
- Prospective registry of 100 patients undergoing PCI.
- Blood samples collected pre-PCI for WBC, CRP, and interleukin-6 analysis.
- Patients stratified by WBC count tertiles; logistic regression used for analysis.
Main Results:
- Patients in the highest WBC tertile were more likely to be smokers, receive unfractionated heparin, have acute coronary syndrome, and elevated CRP.
- Elevated troponin-I pre-PCI was independently associated with the highest WBC count tertile.
- In troponin I-negative patients, CRP >3.0 mg/L independently predicted elevated pre-PCI WBC count.
Conclusions:
- Pre-PCI elevated WBC count in troponin I-negative patients reflects cytokine-mediated inflammation.
- CRP is a significant predictor of elevated WBC count in specific patient subgroups undergoing PCI.
Abstract:
An elevated white blood cell (WBC) count and elevated C-reactive protein (CRP) have been associated with an increased risk of adverse cardiac events. The relation between these 2 parameters of heightened systemic inflammation was characterized in patients who underwent percutaneous coronary intervention (PCI). Femoral arterial blood samples from a prospective registry of 100 patients who underwent PCI were obtained immediately before the procedure. The concentrations of CRP and interleukin-6 were determined by an enzyme-linked immunosorbent assay. Patients were stratified according to tertiles of ascending WBC counts before PCI. Univariate analysis compared patients in the highest WBC count tertile with the lower tertiles for clinical, angiographic, and procedural characteristics, as well as pre-PCI cytokine concentrations. Multiple logistic regression analysis was performed to examine the association between the elevated WBC count and baseline elevations in either CRP or interleukin-6, accounting for the simultaneous effect of confounding characteristics. Approximately 75% of patients had stable or unstable angina pectoris versus a marker-positive acute coronary syndrome. Patients in the highest WBC count tertile were more likely to be smokers, have received unfractionated heparin, have a marker-positive acute coronary syndrome, and have a CRP >3.0 mg/L. Multivariate analysis showed that only elevated troponin-I before PCI was independently associated with the highest WBC count tertile (odds ratio 10.9, 95% confidence interval 3.7 to 32.4, p < 0.01). In patients with negative troponin I findings, CRP >3.0 mg/L was a powerful independent predictor of an elevated pre-PCI WBC count (odds ratio 3.78, 95% confidence interval 1.07 to 13.3, p = 0.04). In conclusion, in patients with troponin I negative coronary syndromes, a pre-PCI elevation in the WBC count reflected cytokine-mediated inflammation.
