TY - JOUR
T1 - White Blood Cell Count Predicts All-Cause Mortality in Patients with Suspected Peripheral Arterial Disease
AU - Arain, Faisal A.
AU - Khaleghi, Mahyar
AU - Bailey, Kent R.
AU - Lahr, Brian D.
AU - Rooke, Thom W.
AU - Kullo, Iftikhar J.
N1 - Funding Information:
Funding: Supported by National Institutes of Health grants HL75794 and HL81331. Dr Arain is supported by the National Institutes of Health Vascular Medicine Training Program K12 grant (HL 083797).
PY - 2009/9
Y1 - 2009/9
N2 - Objective: We investigated whether markers of inflammation-white blood cell (WBC) count, C-reactive protein (CRP), and lipoprotein-associated phospholipase A2-are associated with mortality in patients referred for noninvasive lower-extremity arterial evaluation. Methods: Participants (n = 242, mean age 68 years, 54% men) were followed for a median of 71 months. Ankle-brachial index (ABI), WBC count, plasma CRP, and lipoprotein-associated phospholipase A2 were measured at the start of the study. Factors associated with all-cause mortality were identified using Cox proportional hazards. Results: During the follow-up period, 56 patients (25%) died. Factors associated with higher mortality were greater age, history of coronary artery disease/cerebrovascular disease, lower ABI, higher serum creatinine, and higher WBC count/plasma CRP. In stepwise multivariable regression analysis, ABI, serum creatinine, WBC count, and CRP were associated significantly with mortality. Patients in the top tertile of WBC count and CRP level had a relative risk of mortality of 3.37 (confidence interval [CI], 1.56-7.27) and 2.12 (CI, 0.97-4.62), respectively. However, only the WBC count contributed incrementally to prediction of mortality. Inferences were similar when analyses were limited to patients with peripheral arterial disease (ABI < 0.9, n = 114). Conclusion: WBC count, but not plasma CRP level, provides incremental information about the risk of death in patients referred for lower-extremity arterial evaluation and in the subset of these patients with peripheral arterial disease.
AB - Objective: We investigated whether markers of inflammation-white blood cell (WBC) count, C-reactive protein (CRP), and lipoprotein-associated phospholipase A2-are associated with mortality in patients referred for noninvasive lower-extremity arterial evaluation. Methods: Participants (n = 242, mean age 68 years, 54% men) were followed for a median of 71 months. Ankle-brachial index (ABI), WBC count, plasma CRP, and lipoprotein-associated phospholipase A2 were measured at the start of the study. Factors associated with all-cause mortality were identified using Cox proportional hazards. Results: During the follow-up period, 56 patients (25%) died. Factors associated with higher mortality were greater age, history of coronary artery disease/cerebrovascular disease, lower ABI, higher serum creatinine, and higher WBC count/plasma CRP. In stepwise multivariable regression analysis, ABI, serum creatinine, WBC count, and CRP were associated significantly with mortality. Patients in the top tertile of WBC count and CRP level had a relative risk of mortality of 3.37 (confidence interval [CI], 1.56-7.27) and 2.12 (CI, 0.97-4.62), respectively. However, only the WBC count contributed incrementally to prediction of mortality. Inferences were similar when analyses were limited to patients with peripheral arterial disease (ABI < 0.9, n = 114). Conclusion: WBC count, but not plasma CRP level, provides incremental information about the risk of death in patients referred for lower-extremity arterial evaluation and in the subset of these patients with peripheral arterial disease.
KW - Pathophysiology
KW - Peripheral vascular disease
KW - Risk factors
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U2 - 10.1016/j.amjmed.2009.02.020
DO - 10.1016/j.amjmed.2009.02.020
M3 - Article
C2 - 19699384
AN - SCOPUS:68749095877
SN - 0002-9343
VL - 122
SP - 874.e1-874.e7
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 9
ER -