Zhang Zhiyuan, Wang Heyan, Wang Ruiyu, She Zeyu, Liang Xingyue, Liu Huiyi, Kou Xuemeng, Wang Shipeng
Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China.
Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China.
Vasc Health Risk Manag. 2025 Jan 16;21:25-37. doi: 10.2147/VHRM.S492059. eCollection 2025.
An association between white blood cell count (WBC-C) before percutaneous coronary intervention (PCI) and prognosis has been established in patients undergoing PCI. However, the effect of WBC-C after PCI on the long-term prognosis of patients with unstable angina pectoris (UA) is unclear.
A retrospective cohort study was conducted in 1811 consecutive patients with UA. The changes of WBC and subgroup counts before and in the early postoperative stages after PCI were observed by paired Wilcoxon signed-rank test. The Kaplan-Meier method and COX proportional regression model were used to evaluate the association between the incidence of 5-year endpoint events and post-PCI leukocytosis.
Leukocytosis and neutrocytosis within 24 hours after PCI were observed in majority of patients with UA, while lymphocyte count significantly decreased after PCI in those patients. There were no significant differences in 5-year all-cause mortality and major adverse cardiovascular and cerebrovascular events (MACCE) between patients in the post-PCI leukocytosis and the control group. However, the 5-year incidence of major adverse cardiovascular events (MACE) was significantly increased in the post-PCI leukocytosis group (p = 0.017, Log rank test). Leukocytosis after PCI was independently associated with the occurrence of MACE (hazard ratio: 1.36; 95% confidence interval: 1.06-1.75; p = 0.015).
Peripheral WBC and neutrophil counts within 24 hours after PCI significantly increased in response to PCI in patients with UA, while lymphocyte count significantly decreased after PCI in those patients. The post-PCI leukocytosis offered predictive value for an increased risk of MACE for up to 5 years in patients with UA.
经皮冠状动脉介入治疗（PCI）前白细胞计数（WBC-C）与接受PCI患者的预后之间的关联已得到证实。然而，PCI术后WBC-C对不稳定型心绞痛（UA）患者长期预后的影响尚不清楚。
对1811例连续的UA患者进行了一项回顾性队列研究。采用配对Wilcoxon符号秩检验观察PCI术前及术后早期WBC及其亚组计数的变化。采用Kaplan-Meier法和COX比例回归模型评估PCI术后白细胞增多与5年终点事件发生率之间的关联。
大多数UA患者在PCI术后24小时内出现白细胞增多和中性粒细胞增多，而这些患者PCI术后淋巴细胞计数显著下降。PCI术后白细胞增多组与对照组患者的5年全因死亡率和主要心血管和脑血管不良事件（MACCE）无显著差异。然而，PCI术后白细胞增多组的5年主要心血管不良事件（MACE）发生率显著增加（p = 0.017，对数秩检验）。PCI术后白细胞增多与MACE的发生独立相关（风险比：1.36；95%置信区间：1.06 - 1.75；p = 0.015）。
UA患者PCI术后24小时内外周血WBC和中性粒细胞计数因PCI而显著增加，而这些患者PCI术后淋巴细胞计数显著下降。PCI术后白细胞增多对UA患者长达5年的MACE风险增加具有预测价值。
