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Effect of statins and white blood cell count on mortality in patients with ischemic left ventricular dysfunction

Michael J Lipinski1, Robert E Martin, Michael J Cowley

  • 1Division of Cardiology, Virginia Commonwealth University Health Systems, Richmond 23298-0036, USA.

Clinical Cardiology
|February 16, 2006
PubMed

Insights

Statin therapy improved survival in high-risk patients with coronary artery disease and left ventricular dysfunction undergoing percutaneous coronary intervention (PCI). Elevated white blood cell (WBC) counts predicted mortality, but statins offered significant survival benefits across all WBC levels.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Outcomes Research

Background:

  • Elevated white blood cell (WBC) count is linked to increased morbidity and mortality in acute coronary syndrome.
  • The effect of statin therapy on mortality in patients with elevated WBC counts and coronary artery disease (CAD) is not well-established.

Purpose of the Study:

  • To investigate if statin therapy improves survival in patients with elevated WBC counts undergoing percutaneous coronary intervention (PCI).
  • To assess survival outcomes in high-risk patients with pre-existing left ventricular (LV) dysfunction.

Main Methods:

  • Retrospective analysis of 238 patients undergoing PCI with ejection fraction (EF) ≤ 50% between 1996-1999.
  • Exclusion of patients with prior coronary artery bypass graft (CABG).
  • Mortality data retrieved via the U.S. Social Security Death Index with 3.5-6.5 years follow-up.

Main Results:

  • Patients with WBC count ≥ 10,000 cells/mm³ had significantly worse survival rates (1-year: 86% vs 96%, 3-year: 79% vs 89%).
  • Statin therapy significantly improved survival regardless of WBC count, with a trend for greater benefit in patients with elevated WBCs (OR 5.14).
  • Both statin use and WBC count were independent predictors of mortality via proportional hazard regression.

Conclusions:

  • Statin therapy improves survival in patients undergoing PCI with LV dysfunction, irrespective of WBC count.
  • Elevated WBC count is a significant predictor of mortality in this high-risk population.
  • A trend towards greater survival benefit from statins was observed in patients with elevated WBC counts.
Abstract

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