Preoperative White Blood Cell Count is Independently Associated With Higher Perioperative Cardiac Enzyme Release and Increased 1-Year Mortality After Coronary Artery Bypass Grafting
| Autor: | Abbas Rashid, Nicholas D. Palmer, Nick Newall, Antony D. Grayson, Rodney H. Stables, Walid C. Dihmis, Aung Oo |
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| Rok vydání: | 2006 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment Leukocyte Count Necrosis Predictive Value of Tests White blood cell Internal medicine medicine Creatine Kinase MB Form Humans Coronary Artery Bypass Aged Retrospective Studies Inflammation business.industry Myocardium Hazard ratio Percutaneous coronary intervention Odds ratio Perioperative Middle Aged Prognosis medicine.disease Survival Analysis Confidence interval Treatment Outcome medicine.anatomical_structure Cardiology Female Surgery Morbidity Cardiology and Cardiovascular Medicine business Reperfusion injury Artery |
| Zdroj: | The Annals of Thoracic Surgery. 81:583-589 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2005.08.051 |
| Popis: | Background Elevated preprocedural systemic markers of inflammation, including white blood cell count, have been associated with adverse clinical outcomes after percutaneous coronary intervention. The relationship between preoperative white blood cell count and clinical outcomes after coronary artery bypass grafting is less clear despite increasing evidence that neutrophils participate in reperfusion injury. We sought to determine the relationship between preoperative white blood cell count and in hospital major morbidity and 1-year survival after coronary artery bypass grafting. Methods We prospectively studied 3,024 consecutive isolated coronary artery bypass graft procedures. Preoperative white blood cell count was determined by automated counter, perioperative cardiac enzyme release by the creatine kinase–myocardial band isoenzyme, and all-cause mortality over the first postoperative year taken from a national death registry. Multivariate logistic regression and Cox proportional hazards analyses were performed. Results Preoperative white blood cell count offered as a continuous variable and as five predetermined groups was independently associated with cardiac enzyme release three or more times the upper limit of the reference range (adjusted odds ratio=1.5 per 10 × 10 9 /L increase, 95% confidence interval: 1.2 to 2.0, p = 0.002) and higher 1-year mortality (adjusted hazard ratio=1.6 per 10 × 10 9 /L increase, 95% confidence interval: 1.2 to 2.1, p Conclusions Higher preoperative white blood cell count is independently associated with higher perioperative myonecrosis and 1-year mortality after coronary artery bypass grafting. |
| Databáze: | OpenAIRE |
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