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Clustering of blood cell count abnormalities and future risk of death

Patti, Giuseppe ; Lio, Veronica ; Di Martino, Giuseppe ; Ricci, Fabrizio LU ; Renda, Giulia ; Melander, Olle LU orcid ; Engström, Gunnar LU ; Hamrefors, Viktor LU orcid ; De Caterina, Raffaele and Fedorowski, Artur LU orcid (2021) In European Journal of Clinical Investigation 51(8).
Abstract

BACKGROUND: The identification of novel predictors of poor outcome may help stratify cardiovascular risk. Aim was to evaluate the individual contribution of blood cell count parameters, as well as their clustering, on the risk of death and cardiovascular events over the long term in the population-based Malmö Diet and Cancer Study cohort.

METHODS: In 30,447 individuals (age 57 ± 8 years), we assessed the incidence of all-cause death (primary endpoint) and major adverse cardiovascular events (MACE, secondary outcome measure) according to absence or presence of one, two and three factors at baseline out of the following: anaemia, leukocytosis and thrombocytosis. Median follow-up was 16 years.

RESULTS: The percentages of... (More)

BACKGROUND: The identification of novel predictors of poor outcome may help stratify cardiovascular risk. Aim was to evaluate the individual contribution of blood cell count parameters, as well as their clustering, on the risk of death and cardiovascular events over the long term in the population-based Malmö Diet and Cancer Study cohort.

METHODS: In 30,447 individuals (age 57 ± 8 years), we assessed the incidence of all-cause death (primary endpoint) and major adverse cardiovascular events (MACE, secondary outcome measure) according to absence or presence of one, two and three factors at baseline out of the following: anaemia, leukocytosis and thrombocytosis. Median follow-up was 16 years.

RESULTS: The percentages of all-cause death were 19.5% in individuals without factors, 21.3% in those with one factor, 27.4% with two and 46.4% with three (log-rank test P < .001). The crude incidence of MACE was 28.0%, 29.2%, 35.5% and 57.1%, respectively (log-rank test P < .001). At multivariate analysis, we found a stepwise increase in overall mortality with increasing number of prevalent factors (one factor: HR 1.23, 95% CI 1.14-1.31, P < .001; two factors: 1.61, 1.37-1.89, P < .001; three factors: 2.69, 1.44-5.01, P = .002, vs no factor). Similar findings were observed for the incidence of MACE (one factor: adjusted HR 1.18, 95% CI 1.11-1.24, P < .001; two factors: 1.52, 1.33-1.76, P < .001; three factors: 2.03, 1.21-3.67, P < .001, vs no factor).

CONCLUSIONS: The easily assessable clustering of anaemia, leukocytosis and thrombocytosis heralds higher incidence of death and adverse cardiovascular events.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Clinical Investigation
volume
51
issue
8
publisher
Wiley-Blackwell
external identifiers
  • scopus:85105143090
  • pmid:33960412
ISSN
0014-2972
DOI
10.1111/eci.13562
language
English
LU publication?
yes
id
0cab3c1e-b50e-4894-8a5e-ad555d7a65e7
date added to LUP
2021-05-14 12:09:37
date last changed
2024-04-20 06:09:28
@article{0cab3c1e-b50e-4894-8a5e-ad555d7a65e7,
  abstract     = {{<p>BACKGROUND: The identification of novel predictors of poor outcome may help stratify cardiovascular risk. Aim was to evaluate the individual contribution of blood cell count parameters, as well as their clustering, on the risk of death and cardiovascular events over the long term in the population-based Malmö Diet and Cancer Study cohort.</p><p>METHODS: In 30,447 individuals (age 57 ± 8 years), we assessed the incidence of all-cause death (primary endpoint) and major adverse cardiovascular events (MACE, secondary outcome measure) according to absence or presence of one, two and three factors at baseline out of the following: anaemia, leukocytosis and thrombocytosis. Median follow-up was 16 years.</p><p>RESULTS: The percentages of all-cause death were 19.5% in individuals without factors, 21.3% in those with one factor, 27.4% with two and 46.4% with three (log-rank test P &lt; .001). The crude incidence of MACE was 28.0%, 29.2%, 35.5% and 57.1%, respectively (log-rank test P &lt; .001). At multivariate analysis, we found a stepwise increase in overall mortality with increasing number of prevalent factors (one factor: HR 1.23, 95% CI 1.14-1.31, P &lt; .001; two factors: 1.61, 1.37-1.89, P &lt; .001; three factors: 2.69, 1.44-5.01, P = .002, vs no factor). Similar findings were observed for the incidence of MACE (one factor: adjusted HR 1.18, 95% CI 1.11-1.24, P &lt; .001; two factors: 1.52, 1.33-1.76, P &lt; .001; three factors: 2.03, 1.21-3.67, P &lt; .001, vs no factor).</p><p>CONCLUSIONS: The easily assessable clustering of anaemia, leukocytosis and thrombocytosis heralds higher incidence of death and adverse cardiovascular events.</p>}},
  author       = {{Patti, Giuseppe and Lio, Veronica and Di Martino, Giuseppe and Ricci, Fabrizio and Renda, Giulia and Melander, Olle and Engström, Gunnar and Hamrefors, Viktor and De Caterina, Raffaele and Fedorowski, Artur}},
  issn         = {{0014-2972}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{8}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{European Journal of Clinical Investigation}},
  title        = {{Clustering of blood cell count abnormalities and future risk of death}},
  url          = {{http://dx.doi.org/10.1111/eci.13562}},
  doi          = {{10.1111/eci.13562}},
  volume       = {{51}},
  year         = {{2021}},
}