Elsevier

Atherosclerosis

Volume 172, Issue 1, January 2004, Pages 1-6
Atherosclerosis

Review
Leukocytes and coronary heart disease

https://doi.org/10.1016/S0021-9150(03)00164-3Get rights and content

Abstract

Inflammation has been demonstrated to be an important risk factor for the development of cardiovascular events. Patients with elevated white blood cell counts have been shown to be in a higher risk of developing acute myocardial infarction and acute coronary and vascular events. We review the clinical data of high white blood cell counts and the prognosis, and demonstrate several possible mechanisms. It is possible that measuring white blood cell count and subpopulations could be used for a better way of risk stratification of patients admitted with acute vascular events.

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

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