Effectiveness of the Relative Lymphocyte Count to Predict One-Year Mortality in Patients With Acute Heart Failure

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• 作者：Julio Nú ; ñ ; ez MD^a ; ^{yulnunez@gmail.com} ; Eduardo Nú ; ñ ; ez MD ; MPH^a ; Gema Miñ ; ana MD^a ; Juan Sanchis MD^a ; Vicent Bodí ; MD^a ; Eva Rumiz MD^a ; Patricia Palau MD^a ; Myriam Olivares MD^a ; Pilar Merlos MD^a ; Clara Bonanad MD^a ; Luis Mainar MD^b ; Angel Llà ; cer MD^a
• 刊名：The American Journal of Cardiology
• 出版年：2011
• 出版时间：1 April 2011
• 年：2011
• 卷：107
• 期：7
• 页码：1034-1039
• 全文大小：765 K

文摘

Several works have endorsed a significant role of the immune system and inflammation in the pathogenesis of heart failure. As indirect evidence, an association between a low relative lymphocyte count (RLC % ) and worse outcomes found in this population has been suggested. Nevertheless, the role of RLC % for risk stratification in a large and nonselected population of patients with acute heart failure (AHF) has not yet been determined. Thus, the aim of this study was to determine the association between low RLC % and 1-year mortality in patients with AHF and consequently to define whether it has any role for early risk stratification. A total of 1,192 consecutive patients admitted for AHF were analyzed. Total white blood cell and differential counts were measured on admission. RLC % (calculated as absolute lymphocyte count/total white blood cell count) was categorized in quintiles and its association with all-cause mortality at 1 year assessed using Cox regression. At 1 year, 286 deaths (24 % ) were identified. A negative trend was observed between 1-year mortality rates and quintiles of RLC % : 31.5 % , 27.2 % , 23.1 % , 23 % , and 15.5 % in quintiles 1 to 5, respectively (p for trend <0.001). After thorough covariate adjustment, only patients in the lowest quintile (<9.7 % ) showed an increased risk for mortality (hazard ratio 1.76, 95 % confidence interval 1.17 to 2.65, p = 0.006). When RLC % was modeled with restricted cubic splines, a stepped increase in risk was observed patients in quintile 1: those with RLC % values <7.5 % and <5 % showed 1.95- and 2.66-fold increased risk for death compared to those in the top quintile. In conclusion, in patients with AHF, RLC % is a simple, widely available, and inexpensive biomarker, with potential for identifying patients at increased risk for 1-year mortality.