Value of Absolute Eosinophil Count in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary
Yufei Wang1, Xiaoteng Ma1, Zhiqiang Yang1,2
1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Ministry of Education, Beijing, People's Republic of China.
Insights
Elevated absolute eosinophil count (AEC) is linked to major adverse cardiovascular and cerebrovascular events (MACCEs) in acute coronary syndrome (ACS) patients undergoing PCI. AEC improves risk prediction when combined with the SYNTAX II score.
Area of Science:
- Cardiology
- Hematology
- Inflammation Research
Background:
- Elevated eosinophils often signal inflammation, but their role in cardiovascular events is unclear.
- Investigating the link between absolute eosinophil count (AEC) and adverse cardiovascular outcomes in acute coronary syndrome (ACS) patients.
Purpose of the Study:
- To determine the association between AEC and major adverse cardiovascular and cerebrovascular events (MACCEs) in ACS patients undergoing percutaneous coronary intervention (PCI).
- To assess if integrating AEC with the SYNTAX II score enhances MACCE prediction.
Main Methods:
- Analyzed AEC from 1711 ACS patients undergoing PCI.
- Stratified patients into tertiles based on AEC and assessed MACCEs (cardiovascular death, myocardial infarction, stroke).
- Utilized Cox regression and assessed the predictive value of AEC combined with the SYNTAX II score.
Main Results:
- AEC was independently associated with MACCEs after adjusting for confounders (HR 11.555).
- Higher AEC tertiles showed incrementally higher MACCE risk (T3: HR 1.848, P for trend=0.008).
- Integrating AEC with the SYNTAX II score improved predictive accuracy for MACCEs (AUC increased from 0.701 to 0.728, P=0.020).
Conclusions:
- Absolute eosinophil count is an independent predictor of MACCEs in ACS patients undergoing PCI.
- AEC provides additional predictive value to the SYNTAX II score for MACCEs.
Background And Aims:
Elevated eosinophils typically indicate hypersensitive inflammation; however, their involvement in cardiovascular events remains incompletely understood. We investigated the association between the absolute eosinophil count (AEC) and major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Additionally, we determine whether the integration of AEC with the SYNTAX II score could improve predictive ability.
Methods And Results:
The AECs of 1711 patients with ACS undergoing PCI from June 2016 to November 2017 were analyzed on admission. All recruitments were splitted into three groups based on AEC tertiles and 101 participants underwent one or more noteworthy outcomings. The association between AEC and MACCEs (defined as a composite of cardiovascular death, myocardial infarction [MI], and stroke) was tested by Cox proportional-hazards regression analysis. After adjusting for confounders, AEC was independently associated with MACCEs (HR 11.555, 95% CI: 3.318-40.239). Patients in the lowest AEC tertile (T1) as a reference, those in the higher tertiles had an incrementally higher risk of MACCEs (T3: HR 1.848 95% CI: 1.157-2.952; P for trend=0.008). Inclusion of AEC enhanced the predictive accuracy of the SYNTAX II score for MACCEs (AUC: from 0.701 [95% CI: 0.646-0.756] to 0.728 [95% CI: 0.677-0.780]; DeLong's test, P = 0.020).
Conclusion:
AEC is independently linked to MACCEs in ACS patients who underwent PCI, and adds incremental predictive information to the SYNTAX II score.
