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首页> 外文期刊>The American Journal of Cardiology >Relation of White Blood Cell Count to Bleeding and Ischemic Events in Patients With Acute Coronary Syndrome (from the ATLAS ACS 2-TIMI 51 Trial)
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Relation of White Blood Cell Count to Bleeding and Ischemic Events in Patients With Acute Coronary Syndrome (from the ATLAS ACS 2-TIMI 51 Trial)

机译：急性冠状动脉综合征患者中白细胞计数与缺血性事件的关系（来自阿特拉斯ACS 2-Timi 51试验）

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摘要

An elevated white blood cell (WBC) count is associated with an increased risk of ischemic events among acute coronary syndrome (ACS) patients, but the association between WBC count and bleeding in ACS patients is not well established. The aim of this analysis was to assess and compare the association between WBC count and the occurrence of short- and long-term bleeding and ischemic events. This was a post hoc analysis of the ATLAS ACS2-TIMI 51 trial. A subset of patients had a WBC count measurement at baseline (n = 14,231, 91.6%). Univariate and multivariable Cox proportional hazard models were constructed to determine if there is an association between WBC count at baseline and a composite outcome of Thrombolysis in Myocardial Infarction (TIMI) major and minor bleeds at 30 days and 1 year. Variables with a p <0.2 in the univariate analysis were included as potential parameters in the backward selection process A similar multivariable model was constructed to assess the association between WBC count and a composite ischemic endpoint of cardiovascular death, myocardial infarction and stroke. An increased risk of bleeding per a 1 x 10(9)/L increase in WBC at baseline was observed at 30 days (Adjusted hazard ratio [HR] 1.08 95% confidence interval [CI] 1.01 to 1.17, p = 0.019) but not at 1 year (Adjusted HR 1.02 95% CI 0.97 to 1.08, p = 0.409). Additionally, an increased risk of ischemia per a 1 x 10(9)/L increase in WBC at baseline was observed at 30 days (Adjusted HR 1.07, 95% CI: 1.03 to 1.12, p = 0.002) and at 1 year (Adjusted HR 1.05 95% CI 1.02 to 1.08, p = 0.001 at 1 year). In conclusion, a higher WBC count at baseline was associated with an increased risk of the composite bleeding endpoint by 30 days but not at 1 year. The association between WBC count and the risk of the composite ischemic endpoint was significant at 30 days and 1 year. (C) 2019 Elsevier Inc. All rights reserved.
机译：急性冠状动脉综合征（ACS）患者中缺血事件的风险增加，升高的白细胞（WBC）计数有关，但在ACS患者中的WBC计数和出血之间的关联并不具备好良。该分析的目的是评估和比较WBC计数与短期和长期出血和缺血事件的发生之间的关联。这是ATLAS ACS2-TIMI 51试验的后HOC分析。患者的一部分在基线下有WBC计数测量（n = 14,231,91.6％）。构建单变量和多变量的Cox比例危害模型以确定WBC计数是否存在于基线的关系和心肌梗死（TIMI）主要和轻微出血的溶栓治疗的复合结果。在单变量分析中具有P <0.2的变量作为后向选择过程中的潜在参数，构建了类似的多变量模型，以评估WBC计数与心血管死亡，心肌梗死和中风的复合缺血终点之间的关联。在基线下，在基线上增加了每1×10（9）/ l的风险，在30天（调整危险比[HR] 1.08 95％置信区间[CI] 1.01至1.17，P = 0.019）但没有1年（调整后的HR 1.02 95％CI 0.97至1.08，P = 0.409）。另外，在30天（调整为HR 1.07,95％CI：1.03至1.12，P = 0.002）和1年（调整后，在基线下，每1×10（9）/ L的缺血风险增加的缺血风险增加HR 1.05 95％CI 1.02至1.08，P = 0.001，1年）。总之，基线的WBC计数较高，与复合出血终点的风险增加30天，但不是1年。 WBC计数与复合缺血终点的风险在30天和1年内显着。 （c）2019 Elsevier Inc.保留所有权利。

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    Alkhalfan Fahad; Nafee Tarek; Yee Megan K.; Chi Gerald; Kalayci Arzu; Plotnikov Alexei; Braunwald Eugene; Gibson C. Michael;

  • 作者单位

    Harvard Med Sch Beth Israel Deaconess Med Ctr Div Cardiovasc Med Boston MA 02115 USA;

    Harvard Med Sch Beth Israel Deaconess Med Ctr Div Cardiovasc Med Boston MA 02115 USA;

    Harvard Med Sch Beth Israel Deaconess Med Ctr Div Cardiovasc Med Boston MA 02115 USA;

    Harvard Med Sch Beth Israel Deaconess Med Ctr Div Cardiovasc Med Boston MA 02115 USA;

    Harvard Med Sch Beth Israel Deaconess Med Ctr Div Cardiovasc Med Boston MA 02115 USA;

    Johnson &

    Johnson Pharmaceut Res &

    Dev Raritan NJ USA;

    Harvard Med Sch Brigham &

    Womens Hosp Dept Med Cardiovasc Div Boston MA 02115 USA;

    Harvard Med Sch Beth Israel Deaconess Med Ctr Div Cardiovasc Med Boston MA 02115 USA;

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  • 正文语种 eng
  • 中图分类 心脏、血管（循环系）疾病;
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