High absolute neutrophil count with type 2 diabetes is associated with adverse outcome in patients with coronary artery disease: A large-scale cohort study

Jining He; Zhangyu Lin; Chenxi Song; Rui Zhang; Haoyu Wang; Sheng Yuan; Xiaohui Bian; Qiuting Dong; Kefei Dou

doi:10.3389/fendo.2023.1129633

High absolute neutrophil count with type 2 diabetes is associated with adverse outcome in patients with coronary artery disease: A large-scale cohort study

Front Endocrinol (Lausanne). 2023 Apr 11:14:1129633. doi: 10.3389/fendo.2023.1129633. eCollection 2023.

Authors

Jining He^{1

2}, Zhangyu Lin^{1

2}, Chenxi Song^{1

2}, Rui Zhang^{1

2}, Haoyu Wang^{1

2}, Sheng Yuan^{1

2}, Xiaohui Bian^{1

2}, Qiuting Dong³, Kefei Dou^{1

2}

Affiliations

¹ Cardiometabolic Medicine Center, State Key Laboratory of Cardiovascular Disease, Beijing, China.
² Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
³ Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Abstract

Background: Inflammatory processes crucially modulate the development, progression, and outcomes of coronary artery disease (CAD). Since hyperglycemia could alter inflammatory responses, this study aimed to investigate the effect of ANC, a novel and rapidly available inflammatory biomarker, on the prognosis of patients undergoing PCI with or without type 2 diabetes (T2D).

Methods: A total of 7,826 patients with CAD hospitalized for PCI at Fuwai Hospital were consecutively recruited. According to the median ANC value, patients were stratified as having high ANC (ANC-H) or low ANC (ANC-L) and were further classified into four groups by T2D. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCEs), including all-cause mortality, myocardial infarction, stroke, and target vessel revascularization.

Results: During a median follow-up of 2.4 years, 509 (6.5%) MACCEs were documented. Diabetic patients with increased ANC were at significantly higher risk of MACCEs (aHR, 1.55; 95% CI, 1.21-1.99; P = 0.001) compared to those in the ANC-L/non-T2D group (P for interaction between T2D and ANC categories = 0.044). Meanwhile, multivariable regression analysis demonstrated the highest MACCE risk in diabetic patients with a higher level of ANC than others (P for trend <0.001).

Conclusion: This study suggests that stratification of patients with elevated ANC and T2D could provide prognostic information for CAD patients undergoing PCI.

Keywords: coronary artery disease; neutrophils; percutaneous coronary intervention; prognosis; type 2 diabetes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cohort Studies
Coronary Artery Disease* / complications
Diabetes Mellitus, Type 2* / complications
Humans
Neutrophils
Percutaneous Coronary Intervention* / adverse effects

Grants and funding

This work was supported by the CAMS Innovation Fund for Medical Sciences (CIFMS) [grant number, 2021-I2M-1-008], and the Beijing Municipal Science and Technology Project [grant number, Z211100002921009].