Association of total and differential leukocyte counts with cardiovascular disease and mortality in the UK Biobank

Welsh, C. et al. (2018) Association of total and differential leukocyte counts with cardiovascular disease and mortality in the UK Biobank. Arteriosclerosis, Thrombosis, and Vascular Biology, 38(6), pp. 1415-1423. (doi:10.1161/ATVBAHA.118.310945) (PMID:29699973)

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Abstract

Objective—Elevated white blood cell count is associated with a higher risk of cardiovascular disease (CVD). We aimed to investigate whether specific leukocyte subpopulations, which may more closely indicate a specific inflammatory pathway, are specifically associated with CVD. Approach and Results—Participants (478 259) from UK Biobank with data for white blood cell count were included. Death because of CVD (n=1377) and non-CVD causes (n=8987) occurred during median follow-up time of 7.0 years (interquartile range, 6.3–7.6). In Cox models, deciles of leukocyte counts (lymphocytes, monocytes, neutrophils, eosinophils, and basophils) were examined using the fifth decile as the referent group. Models were stratified by sex and adjusted for a range of classical risk factors. A sensitivity analysis excluded participants with baseline comorbidites and the first 2 years of follow-up. Men (hazard ratio [HR], 1.59; 95% confidence interval, 1.22–2.08) and women (HR, 2.15; 95% confidence interval, 1.38–3.35) in the highest decile of neutrophil count were at higher risk of CVD mortality and nonfatal CVD (men HR, 1.28; 95% confidence interval, 1.16–1.42 and women HR, 1.21; 95% confidence interval, 1.06–1.38). In the sensitivity analysis, the power to investigate CVD mortality was limited, but for both sexes combined, the linear HRs for a 1×109/L cell count increase in white blood cell count and neutrophils, respectively, was 1.05 (1.03–1.07) and 1.07 (1.04–1.11). Conclusions—Among circulating leukocyte subpopulations, neutrophil count in men was most consistently associated with fatal and nonfatal CVD. Further studies of interventions that lower circulating neutrophils, such as canakinumab, are required to investigate causality.

Item Type:Articles
Keywords:Cardiovascular disease, epidemiology, inflammation, leukocyte count, neutrophils.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Celis, Dr Carlos and Gray, Dr Stuart and Gill, Professor Jason and Mark, Dr Patrick and Jhund, Dr Pardeep and Welsh, Dr Paul and Iliodromiti, Dr Stamatina and Pell, Professor Jill and Lewsey, Professor James and Sattar, Professor Naveed and Lyall, Dr Donald and Welsh, Dr Claire
Authors: Welsh, C., Welsh, P., Mark, P. B., Celis-Morales, C. A., Lewsey, J., Gray, S. R., Lyall, D. M., Iliodromiti, S., Gill, J. M.R., Pell, J., Jhund, P. S., and Sattar, N.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > School of Veterinary Medicine
Journal Name:Arteriosclerosis, Thrombosis, and Vascular Biology
Publisher:American Heart Association
ISSN:1079-5642
ISSN (Online):1524-4636
Published Online:26 April 2018
Copyright Holders:Copyright © 2018 American Heart Association, Inc.
First Published:First published in Arteriosclerosis, Thrombosis, and Vascular Biology 38(6):1415-1423
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
720611Associations of blood biomarkers with cardiovascular disease and related cardiometabolic outcomes and risk prediction in the clinical setting: UK biobankNaveed SattarChest Heart & Stroke Scotland (CHSS)Res16/A/165RI CARDIOVASCULAR & MEDICAL SCIENCES