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Assessment of differential leukocyte count in patients with acute coronary syndrome
Tahir Munir Ahmad1, Mohammad Nasir Afzal
1Department of Physiology, Shifa College of Medicine, Shifa International Hospital, Islamabad.
Insights
Elevated monocyte counts predict mortality in acute coronary syndrome (ACS) patients. This finding highlights monocytes as a key prognostic marker for both death risk and myocardial damage extent in ACS.
Area of Science:
- Cardiology
- Hematology
- Clinical Pathology
Background:
- Acute coronary syndrome (ACS) poses a significant mortality risk.
- Identifying reliable prognostic markers is crucial for managing ACS patients.
- Leukocyte subtypes are increasingly recognized for their role in cardiovascular disease.
Purpose of the Study:
- To evaluate the predictive capability of leukocyte subtypes for mortality in patients diagnosed with ACS.
- To determine if specific leukocyte counts can serve as independent predictors of adverse outcomes in ACS.
Main Methods:
- A cohort of 133 consecutive ACS patients was followed for one year.
- Leukocyte counts (total and subtypes) were measured using a Sysmex automated cell counter.
- Cox regression analysis was employed to assess the predictive value of leukocyte counts for mortality.
Main Results:
- Higher total leukocyte, neutrophil, and monocyte counts were observed in ACS patients.
- Monocyte count emerged as an independent predictor of mortality in multivariate analysis, even after accounting for standard risk factors and cardiac biomarkers.
- A significant correlation was found between monocyte count and CK-MB, indicating the extent of myocardial damage.
Conclusions:
- Increased monocyte count is an independent predictor of death in ACS patients.
- Monocyte count serves as a valuable prognostic marker for the extent of myocardial damage in ACS.
- Leukocyte differential counts, particularly monocytes, offer important prognostic information in ACS management.
Objective:
To assess the predictive ability of leukocyte subtypes for mortality in patients with acute coronary syndrome (ACS).
Methods:
One hundred and thirty three consecutive patients of ACS wer assessed in the study and were followed up for one year. Diagnosis was based on clinical characteristics and the laboratory data. The total leukocytes and its subtypes were counted by Sysmex automated cell counter. The predictive ability for death of total count of leukocytes, neutrophils, lymphocytes and monocytes was assessed using Cox regression analysis.
Results:
Univariate analysis revealed higher prevalence of total leukocytes (HR= 1.001, p < or = 0.001) and its subtypes, neutrophils (HR = 1.001, p < or = 0.001) and monocytes (HR 1.006, p < or = 0.001), in patients of ACS. In multivariate modeling, after entering standard coronary risk factors, count of total and differential leukocytes-neutrophils, lymphocytes, monocytes and cardiac biomarkers CK-MB, Trop I; the monocyte count (hazard ratio [HR] 1.004, CI 1.002-1.006, p < 0.0001) was found to be independent predictor for ACS. A significance correlation between monocyte count and CK-MB, representing extent of myocardial damage, was also seen (r = 0.301, p < 0.0001).
Conclusion:
The increase in monocyte count is an independent predictor of death and prognostic marker of the extent of myocardial damage in patients with ACS.
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