Relative Predictive Value of Circulating Immune Markers in US Adults Without Cardiovascular Disease: Implications for Risk Reclassification.

Autor:	Gupta K; Division of Cardiovascular Disease and Comprehensive Cardiovascular Center, University of Alabama at Birmingham, Birmingham, AL; Division of General Internal Medicine, Henry Ford Hospital, Detroit, MI., Kalra R; Cardiovascular Division, University of Minnesota, Minneapolis, MN., Pate M; Division of Cardiovascular Disease and Comprehensive Cardiovascular Center, University of Alabama at Birmingham, Birmingham, AL., Nagalli S; Yuma Regional Medical Center, Yuma, AZ., Ather S; Section of Cardiology, Birmingham Veteran Affairs Medical Center, Birmingham, AL., Rajapreyar I; Division of General Internal Medicine, Henry Ford Hospital, Detroit, MI., Arora P; Division of Cardiovascular Disease and Comprehensive Cardiovascular Center, University of Alabama at Birmingham, Birmingham, AL; Section of Cardiology, Birmingham Veteran Affairs Medical Center, Birmingham, AL., Gupta A; Division of Cardiology, Henry Ford Hospital, Detroit, MI., Zhou W; Cardiology Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD., San Jose Estepar R; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Di Carli M; Cardiovascular Imaging Program, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (M.D.C.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Prabhu SD; Division of Cardiovascular Disease and Comprehensive Cardiovascular Center, University of Alabama at Birmingham, Birmingham, AL; Section of Cardiology, Birmingham Veteran Affairs Medical Center, Birmingham, AL. Electronic address: sprabhu@uabmc.edu., Bajaj NS; Division of Cardiovascular Disease and Comprehensive Cardiovascular Center, University of Alabama at Birmingham, Birmingham, AL; Division of Molecular Imaging and Therapeutics, Department of Radiology, University of Alabama at Birmingham, Birmingham, AL; Section of Cardiology, Birmingham Veteran Affairs Medical Center, Birmingham, AL. Electronic address: nbajaj@uabmc.edu.
Jazyk:	angličtina
Zdroj:	Mayo Clinic proceedings [Mayo Clin Proc] 2021 Jul; Vol. 96 (7), pp. 1812-1821. Date of Electronic Publication: 2021 Apr 09.
DOI:	10.1016/j.mayocp.2020.11.027
Abstrakt:	Objective: To investigate the relative predictive value of circulating immune cell markers for cardiovascular mortality in ambulatory adults without cardiovascular disease. Methods: We analyzed data of participants enrolled in the National Health and Nutrition Examination Survey from January 1, 1999, to December 31, 2010, with the total leukocyte count within a normal range (4000-11,000 cells/μL [to convert to cells ×10 9 /L, multiply by 0.001]) and without cardiovascular disease. The relative predictive value of circulating immune cell markers measured at enrollment-including total leukocyte count, absolute neutrophil count, absolute lymphocyte count, absolute monocyte count, monocyte-lymphocyte ratio (MLR), neutrophil-lymphocyte ratio, and C-reactive protein-for cardiovascular mortality was evaluated. The marker with the best predictive value was added to the 10-year atherosclerotic cardiovascular disease (ASCVD) risk score to estimate net risk reclassification indices for 10-year cardiovascular mortality. Results: Among 21,599 participants eligible for this analysis, the median age was 47 years (interquartile range, 34-63 years); 10,651 (49.2%) participants were women, and 10,713 (49.5%) were self-reported non-Hispanic white. During a median follow-up of 9.6 years (interquartile range, 6.8-13.1 years), there were 627 cardiovascular deaths. MLR had the best predictive value for cardiovascular mortality. The addition of elevated MLR (≥0.3) to the 10-year ASCVD risk score improved the classification by 2.7%±1.4% (P=.04). Elevated MLR had better predictive value than C-reactive protein and several components of the 10-year ASCVD risk score. Conclusion: Among ambulatory US adults without preexisting cardiovascular disease, we found that MLR had the best predictive value for cardiovascular mortality among circulating immune markers. The addition of MLR to the 10-year risk score significantly improved the risk classification of participants. (Published by Elsevier Inc.)
Databáze:	MEDLINE
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