Shiyovich Arthur, Gilutz Harel, Plakht Ygal
Tex Heart Inst J. 2017 Jun 1;44(3):176-188. doi: 10.14503/THIJ-16-5768. eCollection 2017 Jun.
We evaluated the association between white blood cell counts and long-term mortality rates in 2,129 patients (mean age, 65.3 ± 13.5 yr; 69% men) who had survived acute myocardial infarction. We obtained white blood cell counts and differential counts of white blood cell subtypes within the first 72 hours of hospital admission. The primary outcome was all-cause death at 1, 5, and 10 years after acute myocardial infarction. In regard to death in the long term, we found significant negative linear associations (lymphocytes), positive linear associations (neutrophils and the neutrophil-to-lymphocyte ratio), and nonlinear U-shaped associations (basophils, eosinophils, monocytes, and total white blood cell count). After multivariate adjustment for the Soroka Acute Myocardial Infarction risk score, lymphocytes (strongest association), neutrophil-to-lymphocyte ratio, and eosinophils were independently associated with death for up to 10 years after hospital discharge. The independent associations weakened over time. We conclude that lymphocyte count, neutrophil-to-lymphocyte ratio, and eosinophil count are independently and incrementally associated with death in the long term after acute myocardial infarction.
我们评估了2129例急性心肌梗死存活患者（平均年龄65.3±13.5岁；69%为男性）的白细胞计数与长期死亡率之间的关联。我们在患者入院后的72小时内获取了白细胞计数及白细胞各亚型的分类计数。主要结局是急性心肌梗死后1年、5年和10年的全因死亡。对于长期死亡，我们发现了显著的负线性关联（淋巴细胞）、正线性关联（中性粒细胞和中性粒细胞与淋巴细胞比值）以及非线性U型关联（嗜碱性粒细胞、嗜酸性粒细胞、单核细胞和白细胞总数）。在对索罗卡急性心肌梗死风险评分进行多变量调整后，淋巴细胞（关联最强）、中性粒细胞与淋巴细胞比值以及嗜酸性粒细胞在出院后长达10年的时间里与死亡独立相关。这些独立关联随时间逐渐减弱。我们得出结论，淋巴细胞计数、中性粒细胞与淋巴细胞比值以及嗜酸性粒细胞计数在急性心肌梗死后长期与死亡独立且逐步相关。
