Differential leucocyte count and the risk of future coronary artery disease in healthy men and women: the EPIC-Norfolk Prospective Population Study.

TitleDifferential leucocyte count and the risk of future coronary artery disease in healthy men and women: the EPIC-Norfolk Prospective Population Study.
Publication TypeJournal Article
Year of Publication2007
AuthorsRana, JS, Boekholdt, SM, Ridker, PM, Jukema, JW, Luben, R, Bingham, SA, Day, NE, Wareham, NJ, Kastelein, JJP, Khaw, K-T
JournalJ Intern Med
Volume262
Issue6
Pagination678-89
Date Published2007 Dec
ISSN1365-2796
KeywordsAge Factors, Aged, Body Mass Index, C-Reactive Protein, Coronary Disease, Diabetes Mellitus, England, Female, Granulocytes, Humans, Leukocyte Count, Lymphocyte Count, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, Risk, Sex Factors, Smoking, Triglycerides
Abstract

BACKGROUND: We examined the relationship between granulocyte, lymphocyte and monocyte counts and risk of coronary heart disease (CHD) and cardiovascular disease (CVD) in men and women. There is paucity of data on the differential leucocyte count and its relationship with the risk of CHD and CVD.METHODS: This prospective study comprised 7073 men and 9035 women who were 45-79 years of age and were residents of Norfolk. United Kingdom.RESULTS: During an average of 8 years of follow-up we identified 857 incident CHD events and 2581 CVD incident events. Increased total leucocyte count was associated with increased risk for both CHD and CVD. The highest quartile of granulocyte count was associated with increased risk when compared to lowest quartile for CHD (men HR 1.70 95% CI: 1.30-2.21; women HR 1.24 95% CI: 0.91-1.69) and for CVD (men HR 1.46 95% CI: 1.24-1.71; women HR 1.20 95% CI: 1.02-1.42). The association remained unchanged when the analyses were restricted to nonsmokers and when risk was assessed for every 1000 cells L(-1) increase in cell count. In multivariable models, despite adjusting for C-reactive protein (CRP), the granulocyte count remained an independent predictor of CHD and CVD risk, especially amongst men. Lymphocyte or monocyte counts were not significantly associated with increased risk. In all analyses, additionally adjusting for CRP did not affect the results materially.CONCLUSIONS: In conclusion, we found that the higher risk for CHD and CVD associated with increased total leucocyte count seems to be accounted for by the increased granulocyte count.

DOI10.1111/j.1365-2796.2007.01864.x
Alternate JournalJ. Intern. Med.
Citation Key10.1111/j.1365-2796.2007.01864.x
PubMed ID17908163
Grant ListG0401527 / / Medical Research Council / United Kingdom
MC_U105630924 / / Medical Research Council / United Kingdom
MC_U106179471 / / Medical Research Council / United Kingdom
/ / Wellcome Trust / United Kingdom