Association between inflammation and cardiovascular disease in the absence of risk factors

Evidence about whether neutrophil counts are associated with cardiovascular disease (CVD) in adults without traditional atherosclerotic cardiovascular disease (ASCVD) risk factors based on current definitions is scant. We investigated the association of neutrophil count and risk of CVD among healthy individuals.

We derived data from the Kailuan Study. This study included 35,975 participants (men, 69.8 %; mean age, 47.7 [12.6] years) who were free of a history of CVD, absent of ASCVD risk factors, during 2006-2007, participants were followed up until new-onset CVD event, death or December 31, 2021. Participants were categorized into 3 groups according to the tertile of neutrophil counts. The primary outcome was composite CVD (nonfatal myocardial infarction and stroke) form baseline through December 31, 2021. During a median follow-up of 14.98 years, we observed 1859 incident CVD events. Compared with the first tertile, the second and third tertiles of neutrophil counts were associated with increased risk of CVD (adjusted hazard ratio 1.42 [95 % confidence interval (CI) 1.27-1.59]), and 1.34 (95 %CI 1.19-1.50), respectively, P for trend <0.001. Similar results were observed for the endpoint of myocardial infarction and stroke. Parallel results were found for hs-CRP. Multivariable-adjusted spline regression model showed a J-shaped association between neutrophil counts and the risk of CVD.

In this study, higher levels of neutrophil counts were associated with an increased risk of CVD, in participants without traditional ASCVD risk factors. Our study consisted predominantly of male participants, which may limit the generalizability of our findings.