Abstract
BackgroundBoth coronary artery disease (CAD) and diabetes mellitus (DM) are associated with inflammation. However, whether and which leukocytes can predict the presence and extent of CAD in patients with DM has not been investigated. The aim of the present study was to examine the association of leukocyte and its subsets counts with the severity of CAD in patients with DM.Methods and FindingsThree hundred and seventy-three diabetic patients who were scheduled for coronary angiography due to typical stable angina pectoris were enrolled in this study. They were classified into the three groups according to tertiles of Gensini score (GS, low group <8, n = 143; intermediate group 8∼28, n = 109; high group >28, n = 121). The relationship between the leukocyte and its subsets counts with the severity of CAD were evaluated. The data indicated that there were significant correlations between leukocyte and neutrophil counts with GS (r = 0.154 and 0.156, respectively, all P<0.003 for Pearson's correlation). Similarly, area under the receivers operating characteristic curve of leukocyte and neutrophil counts were 0.61 and 0.60 respectively (95%CI: 0.55–0.67, all P = 0.001) for predicting high GS. Multivariate logistic regression analysis demonstrated that leukocyte count was an independent predictor for high GS patients with DM (OR = 1.20, 95%CI 1.03–1.39, P = 0.023) after adjusting for conventional risk factors of CAD.ConclusionsCompared with its subsets, leukocyte count appeared to be an independent predictor for the severity of CAD and the optimal cut-off value for predicting high GS (>28 points) was 5.0×109 cells/L in diabetic patients.
Highlights
Compared with its subsets, leukocyte count appeared to be an independent predictor for the severity of coronary artery disease (CAD) and the optimal cut-off value for predicting high Gensini Score (GS) (.28 points) was 5.06109 cells/L in diabetic patients
Since low grade of local and systemic inflammation is characteristic of all stages of atherosclerosis, multiple markers of inflammation have been intensively evaluated as potential risk factors for the development of coronary artery disease (CAD) and its complications, such as high-sensitivity C-reactive protein, interleukin-6, fibrinogen, leukocyte and its subsets counts [1,2,3,4,5,6]
In patients with moderate and high-risk of non-ST-segment elevation acute coronary syndrome (ACS), increased leukocyte count at admission in the clinic was an independent predictor of major bleeding at 30 days, or mortality at 1 year [14]
Summary
Since low grade of local and systemic inflammation is characteristic of all stages of atherosclerosis, multiple markers of inflammation have been intensively evaluated as potential risk factors for the development of coronary artery disease (CAD) and its complications, such as high-sensitivity C-reactive protein (hsCRP), interleukin-6, fibrinogen, leukocyte and its subsets counts [1,2,3,4,5,6]. A study indicated that the leukocyte count was qualified to predict myocardial infarct size whereas CRP was not in patients with ST-segment elevated myocardial infarction who had been treated with primary percutaneous coronary intervention [23]. Based on these studies, high leukocyte and its subsets counts, even within the normal range, appeared to be linked to systemic inflammatory response and to increased risk of cardiovascular disease and adverse prognosis.
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