Preprocedural white blood cell count as a predictor of death and major adverse cardiac events in patients undergoing percutaneous coronary intervention with drug-eluting stents.
BACKGROUND
Patients with elevated white blood cell (WBC) counts who undergo percutaneous coronary intervention (PCI) are at increased risk for short- and long-term mortality as well as major adverse cardiac events (MACE). We assessed the relationship between elevated WBC counts and clinical events in patients who underwent PCI with drug-eluting stents (DES).


METHODS
Our retrospective study includes 878 consecutive patients who underwent both elective and emergent PCI with DES at the UCLA Medical Center. The cohort was divided into tertiles based upon the presenting WBC count: 2.8-6.3 x 109 cells/L (tertile 1 [T1]), 6.4-8.7 x 109 cells/L (tertile 2 [T2]), > or = 8.8 x 109 cells/L (tertile 3 [T3]).


RESULTS
Survival at 1 year was significantly different between all three tertiles, and was poorest in patients with WBC counts in T3 (93.9%-T1, 98.4%-T2, 87.3%-T3; p < 0.0001), while T2 had the highest survival rate at 1 year. Age, chronic renal insufficiency, chronic obstructive pulmonary disease, low WBC count in T1, elevated WBC count in T3 and presentation with myocardial infarction were identified as multivariable predictors for survival at 1 year.


CONCLUSIONS
Both elevated and low WBC counts are associated with increased mortality and MACE at 1 year following PCI with DES. WBC count is an independent predictor of survival in patients who undergo PCI with DES implantation.
David Geffen School of Medicine at University of California, Los Angeles, Division of Cardiology, Los Angeles, California 90095, USA.
Daniel L
DL
Jurewitz
Antonio
A
Pessegueiro
Raymond
R
Zimmer
Ravi
R
Bhatia
Jonathan
J
Tobis
Michael S
MS
Lee
D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D015331:Cohort Studies; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality; D007958:Leukocyte Count; D009203:Myocardial Infarction / Q000401:mortality*; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate