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Prognostic implication of monocytes in atrial fibrillation: The West Birmingham Atrial Fibrillation Project

Farhan Shahid1, Nur A Rahmat1, Gregory Y H Lip1

  • 1Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom.

Plos One
|July 19, 2018
PubMed

Insights

High monocyte counts in atrial fibrillation (AF) patients predict increased risk of death and major adverse cardiovascular events (MACE). Persistent high monocyte levels also correlate with a higher risk of major bleeding, highlighting their prognostic value.

Area of Science:

  • Cardiology
  • Hematology
  • Clinical Research

Background:

  • High monocyte counts are linked to adverse outcomes in cardiovascular disease.
  • The prognostic significance of monocyte counts in atrial fibrillation (AF) patients remains unclear.

Purpose of the Study:

  • To investigate the utility of monocyte counts as a prognostic marker in patients with atrial fibrillation.
  • To determine if monocyte levels can predict adverse outcomes in AF patients.

Main Methods:

  • Blood samples were analyzed for monocyte counts in 881 AF patients.
  • Outcomes assessed included all-cause death, major adverse cardiovascular events (MACE), stroke/systemic embolism (SSE), and major bleeding.
  • Cox regression analysis was used to evaluate the association between monocyte counts and outcomes, adjusting for established risk scores.

Main Results:

  • Over a median follow-up of 7.2 years, 44% of patients died and 48% experienced MACE.
  • The highest quartile of monocyte counts (≥580 μL) was independently associated with increased risk of death (HR 1.64) and MACE (HR 1.58).
  • Persistent high monocyte levels were linked to further increased risk of death, MACE, and significantly higher rates of major bleeding (HR 2.77).

Conclusions:

  • Elevated monocyte counts independently predict MACE, major bleeding, and mortality in AF patients.
  • Monocyte counts do not appear to predict SSE in this cohort.
  • Further research into the pathophysiological mechanisms is needed to elucidate the link between monocytes and thrombotic/bleeding risks in AF.
Abstract

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