ReviewLeukocytes and coronary heart disease
Section snippets
WBCs and coronary heart disease risk
Studies published in 1974 already found that the WBC count was a strong predictor of infarction [1]. The predictive value of the WBC count was similar to that of serum total cholesterol or a single determination of blood pressure. Later on it was found that smokers with WBC counts in excess of 9000 per μl had an increased risk to develop AMI, four times greater than smokers with a leukocyte count below 6000 per μl [2] (Fig. 1).
Another study demonstrated that a total WBC count in excess of
The WBC count might serve as a marker for one or more disease processes that lead to vascular injury and ultimately to ischemia
An elevated WBC count may be a marker for chronic inflammation secondary to tobacco smoking and also from other than tobacco smoking and this inflammation could contribute to ischemic risk [9]. Alternatively, a high WBC count might be seen as a manifestation of a “hematological stress syndrome” [10]; this syndrome has been described to include a variety of other hematologic abnormalities and has been argued to represent a nonspecific response to (or marker for) atherosclerosis [11].
“Stress” is
Summary
Inflammation has been demonstrated to be an important risk factor for the development of cardiovascular events. Patients with elevated WBC counts have been shown to have a higher risk of developing an AMI and to be at higher risk for adverse events during the acute setting. In this review we reviewed the clinical data on the association between WBC count of AMI patients (on admission) and the prognostic outcome of these patients, we discussed possible mechanisms and the possible correlation
References (65)
- et al.
Leukocyte counts and cerebrovascular disease
J. Chronic Dis.
(1982) - et al.
Effect of elevated leukocyte count on in-hospital mortality following acute myocardial infarction
Am. J. Cardiol.
(1996) - et al.
Augmentation by platelets of granulocyte aggregation in response to chemotaxins: studies utilizing an improved cell preparation technique
Blood
(1983) - et al.
Inflamed fibronectin: an altered fibronectin enhances neutrophil adherence
Blood
(1983) - et al.
Procoagulant inflammatory responses of monocytes after direct balloon angioplasty in acute myocardial infarction
Am. J. Cardiol.
(1998) - et al.
Basic mechanisms in congestive heart failure: recognizing the role of proinflammatory cytokines
Chest
(1994) - et al.
Induction of cytokine expression in leukocytes in acute myocardial infarction
J. Am. Coll. Cardiol.
(1997) - et al.
Neutrophil rolling, arrest, and transmigration across activated, surface-adherent platelets via sequential action of P-selectin and the beta 2-integrin CD11b/CD18
Blood
(1996) - et al.
Expression of vascular endothelial growth factor in patients with acute myocardial infarction
J. Am. Coll. Cardiol.
(2000) - et al.
Increased expression of neutrophil and monocyte adhesion molecules LFA-1 and Mac-1 and their ligand ICAM-1 and VLA-4 throughout the acute phase of myocardial infarction: possible implications for leukocyte aggregation and microvascular plugging
J. Am. Coll. Cardiol.
(1998)