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    Elevated leukocyte count and adverse hospital events in patients with acute coronary syndromes: findings from the Global Registry of Acute Coronary Events (GRACE)

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    Authors
    Furman, Mark I.
    Gore, Joel M.
    Anderson, Frederick A.
    Budaj, Andrzej
    Goodman, Shaun G.
    Avezum, Ávaro
    López-Sendón, José
    Klein, Werner
    Mukherjee, Debabrata
    Eagle, Kim A.
    Dabbous, Omar H.
    Goldberg, Robert J.
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    UMass Chan Affiliations
    Department of Surgery
    Department of Medicine, Division of Cardiovascular Medicine
    Document Type
    Journal Article
    Publication Date
    2004-01-24
    Keywords
    Adult
    Aged
    Analysis of Variance
    Angina, Unstable
    Arrhythmias, Cardiac
    Female
    Heart Failure
    *Hospital Mortality
    Humans
    Inflammation
    *Leukocyte Count
    Male
    Middle Aged
    Myocardial Infarction
    Predictive Value of Tests
    Syndrome
    Biostatistics
    Cardiovascular Diseases
    Epidemiology
    Health Services Research
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    Link to Full Text
    http://dx.doi.org/10.1016/j.ahj.2003.07.003
    Abstract
    OBJECTIVE: To examine the association between elevated leukocyte count and hospital mortality and heart failure in patients enrolled in the multinational, observational Global Registry of Acute Coronary Events (GRACE). BACKGROUND: Elevated leukocyte count is associated with adverse hospital outcomes in patients presenting with acute myocardial infarction (AMI). The association of this prognostic factor with hospital mortality and heart failure in patients with other acute coronary syndromes (ACS) is unclear. METHODS: We examined the association between admission leukocyte count and hospital mortality and heart failure in 8269 patients presenting with an ACS. This association was examined separately in patients with ST-segment elevation AMI, non-ST-segment elevation AMI, and unstable angina. Leukocyte count was divided into 4 mutually exclusive groups (Q): Q1 <6000, Q2 = 6000-9999, Q3 = 10,000-11,999, Q4 >12,000. Multiple logistic regression analysis was performed to examine the association between elevated leukocyte count and hospital events while accounting for the simultaneous effect of several potentially confounding variables. RESULTS: Increasing leukocyte count was significantly associated with hospital death (adjusted odds ratio [OR] 2.8, 95% CI 2.1-3.6 for Q4 compared to Q2 [normal range]) and heart failure (OR 2.7, 95% CI 2.2-3.4) for patients presenting with ACS. This association was seen in patients with ST-segment elevation AMI (OR for hospital death 3.2, 95% CI 2.1-4.7; OR for heart failure 2.4, 95% CI 1.8-3.3), non-ST-segment elevation AMI (OR for hospital death 1.9, 95% CI 1.2-3.0; OR for heart failure 1.7, 95% CI 1.1-2.5), or unstable angina (OR for hospital death 2.8, 95% CI 1.4-5.5; OR for heart failure 2.0, 95% CI 0.9-4.4). CONCLUSION: In men and women of all ages with the spectrum of ACS, initial leukocyte count is an independent predictor of hospital death and the development of heart failure.
    Source
    Am Heart J. 2004 Jan;147(1):42-8.
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47174
    PubMed ID
    14691417
    Related Resources
    Link to Article in PubMed
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    Population and Quantitative Health Sciences Publications

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