title: Temporal increases in subclinical levels of inflammation are associated with adverse clinical outcomes in patients with left ventricular dysfunction.
abstract: BACKGROUND
  The implication of various cytokines in a subclinical inflammatory process has been documented in heart failure (HF). The role of temporal changes of more conventional markers of inflammation, such as the white blood cell (WBC) count, on clinical outcomes remains largely unknown.
  
  
  RESULTS
  We performed a retrospective analysis of patients included in the Studies Of Left Ventricular Dysfunction that had documented eligibility at the baseline visit, a documented WBC count at baseline and at least 1 measurement during follow-up. We evaluated the association between variations in WBC count, WBC subfractions and mortality and non-fatal events. An increase in WBC count during follow-up compared with baseline was associated with a significantly higher risk of all-cause and cardiovascular (CV) mortality, HF mortality and arrhythmic death (all P < .05). A relative increase in the neutrophil count was associated with higher risk of all-cause and CV mortality, HF mortality and cardiac ischemic events (all P < .05). No significant interaction was present in regards to the etiology of HF.
  
  
  CONCLUSIONS
  Temporal increases in WBC and neutrophil counts are associated with increased risks of death and CV events. This relationship appears to be independent of HF etiology.
authors.affiliation: Faculty of Pharmacy, University of Montreal, Montreal, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: De Denus
authors.forename: Michel
authors.initials: M
authors.lastname: White
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Tardif
authors.forename: Martial G
authors.initials: MG
authors.lastname: Bourassa
authors.forename: Normand
authors.initials: N
authors.lastname: Racine
authors.forename: Sylvie
authors.initials: S
authors.lastname: Levesque
authors.forename: Anique
authors.initials: A
authors.lastname: Ducharme
mesh_terms: D000368:Aged; D001772:Blood Cell Count; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D004656:Enalapril / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000150:complications*; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000401:mortality / Q000503:physiopathology*
chemical_list: D004656:Enalapril