Elements of the complete blood count associated with cardiovascular disease incidence: Findings from the EPIC-NL cohort study

Camille Lassale,W M Monique Verschuren,Yvonne T Van Der Schouw,Yunxia Lu,Itziar Abete,Alyscia Curtis,H B Bueno-De-Mesquita

doi:10.1038/s41598-018-21661-x

Abstract

All blood cells (white blood cells [WBC], red blood cells [RBC] and platelets) can play a role in atherosclerosis. Complete blood count (CBC) is widely available in clinical practice but utility as potential risk factors for cardiovascular disease (CVD) is uncertain. Our aim was to assess the associations of pre-diagnostic CBC with incidence of CVD in 14,362 adults free of CVD and aged 47.8 (±11.7) years at baseline, followed-up for 11.4 years (992 incident cases). Cox proportional hazards regressions were used to estimate HRs and 95%CI. Comparing the top (T3) to bottom (T1) tertile, increased total WBC, lymphocyte, monocyte and neutrophil counts were associated with higher CVD risk: 1.31 (1.10; 1.55), 1.20 (1.02; 1.41), 1.21 (1.03; 1.41) and 1.24 (1.05; 1.47), as well as mean corpuscular volume (MCV: 1.23 [1.04; 1.46]) and red cell distribution width (RDW: 1.22 [1.03; 1.44]). Platelets displayed an association for count values above the clinically normal range: 1.49 (1.00; 2.22). To conclude, total and differential WBC count, MCV, RDW and platelet count likely play a role in the aetiology of CVD but only WBC provide a modest improvement for the prediction of 10-year CVD risk over traditional CVD risk factors in a general population.

Highlights

Neither red blood cell (RBC) count nor haematocrit were linearly associated with risk of cardiovascular disease (CVD), stroke or CHD in both models (Fig. 1, Supplemental Table 2)
We found that increased total white blood cells (WBC), lymphocyte, monocyte and neutrophil counts were associated with higher risk of incident CVD
Together with the positive integrated discrimination improvement (IDI) for counts of total and subtypes of WBC, our results suggest that WBC count provided by simple complete blood count test may me as useful as a CRP testing to help identifying individuals at risk of future CVD

Summary

Objectives

Our aim was to assess the associations of pre-diagnostic CBC with incidence of CVD in 14,362 adults free of CVD and aged 47.8 (±11.7) years at baseline, followed-up for 11.4 years (992 incident cases). We aimed to identify components of the complete blood count, which are reported in routine clinical practice, associated with long-term risk of CVD

Methods

Results

Discussion

Conclusion