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Published on: January 28, 2020
Eosinophil count predicts mortality following percutaneous coronary intervention
Iqbal S Toor1, Rumi Jaumdally, Gregory Y H Lip
1Department of Cardiology, City Hospital, Birmingham B18 7QH, UK.
Insights
High eosinophil counts initially predicted better outcomes in coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI). However, elevated eosinophils were later associated with increased long-term mortality risk.
Area of Science:
- Cardiology
- Inflammation Biology
- Biomarker Discovery
Background:
- Inflammatory markers predict atherosclerosis and adverse outcomes in symptomatic coronary artery disease (CAD).
- The prognostic value of eosinophil count in low-to-intermediate risk CAD patients remains under investigation.
Purpose of the Study:
- To investigate the prognostic role of pre-procedural eosinophil count in patients with CAD undergoing percutaneous coronary intervention (PCI).
Main Methods:
- A cohort of 909 patients undergoing elective or urgent PCI between April 2002 and December 2004 were analyzed.
- Pre-procedural white blood cell differential counts, including eosinophils, were measured.
- Mortality outcomes were analyzed based on tertiles of eosinophil counts, adjusting for baseline characteristics.
Main Results:
- Over a median follow-up of 54 months, 138 deaths (15.2%) occurred.
- High pre-procedural eosinophil counts (top tertile) were associated with reduced mortality within the first 6 months (OR=0.23).
- Conversely, high eosinophil counts were linked to increased mortality risk after 6 months (OR=2.21).
Conclusions:
- Eosinophil count serves as a novel biomarker for risk stratification in CAD patients.
- An initially reduced mortality risk observed with higher eosinophil counts reverses to an increased risk after 6 months post-PCI.
Introduction:
Several inflammatory markers have been shown to be independent predictors for both the development of clinically significant atherosclerosis and for adverse outcome in patients with symptomatic coronary artery disease (CAD). We investigated the prognostic role of eosinophil count in low to intermediate risk patients with CAD.
Methods:
We studied 909 patients admitted for elective or urgent percutaneous coronary intervention (PCI) from April 2002 to December 2004, and measured pre-procedural total and differential white blood cell (WBC) counts. Inter-tertile WBC differences in short (6months) and long term (up to 74months) mortality were analysed after adjusting for differences in baseline characteristics.
Results:
Over a median period of 54months (inter-quartile range 47-65), a total of 138 deaths (15.2%) occurred, of which 24 were in the first 6months of follow-up. Cox regression analysis showed that high pre-procedural eosinophil count (top tertile) was associated with improved outcome within the first 6months (OR=0.23 [0.06-0.84]; p=0.03) but after this period there was an increased risk of mortality (OR=2.21, [1.26-3.88]; p=0.006).
Conclusions:
Eosinophil count is a novel biomarker for risk stratification of CAD patients, which was associated initially with reduced mortality, but after 6months with increased mortality.
