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Predictor of CV Events and Mortality in Postmenopausal Women: Leukocyte Count

Predictor of CV Events and Mortality in Postmenopausal Women: Leukocyte Count. Background and objective. Background: Increasing evidence supports a role for inflammation in the atherosclerotic process

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Predictor of CV Events and Mortality in Postmenopausal Women: Leukocyte Count

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  1. Predictor of CV Events and Mortality in Postmenopausal Women: Leukocyte Count

  2. Background and objective Background: Increasing evidence supports a role for inflammation in the atherosclerotic process Objective: Describe relationship between baseline leukocyte (WBC) count, future CVD events, and mortality in postmenopausal women Source: Women’s Health Initiative Observational Study Margolis KL et al. Arch Intern Med. 2005;165:500-8.

  3. WHI-OS: Women’s Health Initiative Observational Study • Prospective cohort study in 40 US clinical centers • 72,242 postmenopausal women age 50–79 yrs, free of CVD and cancer at baseline • Main outcome measures: fatal CHD, nonfatal MI, stroke, total mortality Margolis KL et al. Arch Intern Med. 2005;165:500-8.

  4. WHI-OS: Baseline characteristics PatientsCharacteristic (N = 72,242) Age (yr) 63.1 White (%) 83.5 Diabetes (%) 4.5 Hypertension (%) 34.6 Elevated cholesterol (%) 12.8 Current smoker (%) 6.1 BMI (kg/m2) 27.1 Margolis KL et al. Arch Intern Med. 2005;165:500-8.

  5. WHI-OS: CHD risk according to WBC count quartile P = 0.02 2.5 2.32 2.0 1.5 OR 0.99 1.00 1.0 0.83 0.5 0 Q12.6–4.9 Q25.0–5.9 Q36.0–7.2 Q47.3–13.35 Quartile of WBC count ( 103 cells/mm3) Ptrend = 0.01Adjusted for all risk factors, including CRP Margolis KL et al. Arch Intern Med. 2005;165:500-8.

  6. WHI-OS: CHD risk according to CRP quartile 2.5 P = 0.07 1.95 2.0 1.5 OR 1.16 1.00 0.94 1.0 0.5 0 Q10.02–0.12 Q20.13–0.27 Q30.28–0.59 Q40.60–4.26 Quartile of CRP level (mg/dL) Ptrend = 0.02Adjusted for all risk factors, including WBC count Margolis KL et al. Arch Intern Med. 2005;165:500-8.

  7. WHI-OS: CHD risk in highest WBC count quartile, according to CRP level 6.80* 7.0 6.0 5.0 4.0 OR 3.10 3.0 2.83 2.70 2.0 1.0 0 Q10.02–0.12 Q20.13–0.27 Q30.28–0.59 Q40.60–4.26 Quartile of CRP level (mg/dL) *P < 0.001Bivariate logistic regression model based on joint WBC count  CRP relationship, adjusted for TC/HDL-C ratio Margolis KL et al. Arch Intern Med. 2005;165:500-8.

  8. Clinical implications • WBC count >6.7  103 cells/mm3 may identify women at high CVD risk who are not currently identified by traditional CVD risk factors • WBC count offers stable, well-standardized, widely available, and inexpensive measure of systemic inflammation • Findings add to evidence in men that suggests a similar link; suggest WBC count is predictive independent of CRP Margolis KL et al. Arch Intern Med. 2005;165:500-8.

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