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Absolute eosinophils count and the extent of coronary artery disease: a single centre cohort study

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Abstract

Leukocytes have been involved in the pathogenesis of atherosclerosis, and recent attention has been raised on eosinophils, that have been claimed for a wide number of cardiovascular pathologies, affecting endocardium, myocardium and vascular walls. However, few data have been reported so far on the relationship between absolute eosinophils count (AEC) and the prevalence and extent of coronary artery disease (CAD), that was the aim of present study. Consecutive patients undergoing non-urgent coronary angiography were included. Haematological parameters were measured at admission. Significant CAD was defined as at least 1 vessel stenosis >50 %, while severe CAD as left main and/or trivessel disease, as evaluated by Quantitative Coronary Angiography. Our population is represented by 3,742 patients, divided according to tertiles values of AEC (≤0.1; 0.1–0.2; >0.2 × 103/µl). Higher eosinophils values were significantly associated to male gender, main established cardiovascular risk factors, previous percutaneous or surgical coronary revascularization, antihypertensive and antiplatelet therapy at admission but inversely with acute presentation. Higher AEC was directly related with platelets count (p < 0.001), haemoglobin levels (p = 0.02), white blood cells count (p = 0.02), higher serum creatinine (p < 0.001), triglycerides (p < 0.001) and glycosylated haemoglobin (p < 0.001), while inversely with HDL cholesterol (p < 0.001). AEC was associated with multivessel disease (p = 0.03), chronic occlusions (p = 0.01), in-stent restenosis (p = 0.002), while inversely with the presence of intracoronary thrombus (p < 0.001). A significant relationship was found between AEC and the prevalence of coronary artery disease (p = 0.049), but not for the extent of more severe LM/trivessel CAD (p = 0.31). At multivariate analysis no independent role of eosinophils was found for CAD (adjusted OR [95 % CI] = 1.02 [0.91–1.15], p = 0.70), or severe CAD (adjusted OR [95 % CI] = 0.99 [0.89–1.1], p = 0.9), even when considering separately acute and elective patients. In conclusion, among patients undergoing coronary angiography, higher eosinophils levels are not independently associated with the prevalence and extent of coronary artery disease, but appear confounded by their link with major cardiovascular risk factors.

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References

  1. De Luca G, Biondi-Zoccai G, Marino P (2008) Transferring patients with ST-segment elevation myocardial infarction for mechanical reperfusion: a meta-regression analysis of randomized trials. Ann Emerg Med 52:665–676

    Article  PubMed  Google Scholar 

  2. De Luca G, Suryapranata H, Marino P (2008) Reperfusion strategies in acute ST-elevation myocardial infarction: an overview of current status. Prog Cardiovasc Dis 50:352–382

    Article  PubMed  Google Scholar 

  3. Navarese EP, De Luca G, Castriota F, Kozinski M, Gurbel PA, Gibson CM, Andreotti F, Buffon A, Siller-Matula JM, Sukiennik A, De Servi S, Kubica J (2011) Low-molecular-weight heparins vs. unfractionated heparin in the setting of percutaneous coronary intervention for ST-elevation myocardial infarction: a meta-analysis. J Thromb Haemost 9:1902–1915

    Article  CAS  PubMed  Google Scholar 

  4. Capozzolo C, Piscione F, De Luca G, Cioppa A, Mazzarotto P, Leosco D, Golino P, Indolfi C, Chiariello M (2001) Direct coronary stenting: effect on coronary blood flow, immediate and late clinical results. Catheter Cardiovasc Interv 53:464–473

    Article  CAS  PubMed  Google Scholar 

  5. De Luca G, Gibson CM, Bellandi F, Noc M, Dudek D, Zeymer U, Arntz HR, Cutlip D, Maioli M, Zorman S, Mesquita Gabriel H, Emre A, Rakowski T, Gyongyosi M, Huber K, Van’t Hof AW (2009) Diabetes mellitus is associated with distal embolization, impaired myocardial perfusion, and higher mortality in patients with ST-segment elevation myocardial infarction treated with primary angioplasty and glycoprotein IIb–IIIa inhibitors. Atherosclerosis 207:181–185

    Article  PubMed  Google Scholar 

  6. De Luca G, Maas AC, Suryapranata H, Ottervanger JP, Hoorntje JC, Gosselink AT, Dambrink JH, de Boer MJ, van ‘t Hof AW (2005) Prognostic significance of residual cumulative ST-segment deviation after mechanical reperfusion in patients with ST-segment elevation myocardial infarction. Am Heart J 150:1248–1254

    Article  PubMed  Google Scholar 

  7. Christodoulidis G, Vittorio TJ, Fudim M, Lerakis S, Kosmas CE (2014) Inflammation in coronary artery disease. Cardiol Rev. doi:10.1097/CRD.0000000000000006

  8. Freidman GD, Klatsky AL, Siegelaub AB (1974) The leukocyte count as a predictor of myocardial infarction. N Engl J Med 290:1275–1278

    Article  Google Scholar 

  9. Madjid M, Awan I, Willerson JT, Casscells SW (1990) Leukocyte count and coronary heart disease: implications for risk assessment. J Am Coll Cardiol 44:1945–1956

    Article  Google Scholar 

  10. Young JD, Peterson CG, Venge P, Cohn ZA (1986) Mechanism of membrane damage mediated by human eosinophil cationic protein. Nature 321(6070):613–616

    Article  CAS  PubMed  Google Scholar 

  11. Mukai HY, Ninomiya H, Ohtani K, Nagasawa T, Abe T (1995) Major basic protein binding to thrombomodulin potentially contributes to the thrombosis in patients with eosinophilia. Br J Haematol 90(4):892–899

    Article  CAS  PubMed  Google Scholar 

  12. Gudbjartsson DF, Bjornsdottir US, Halapi E, Helgadottir A, Sulem P, Jonsdottir GM et al (2009) Sequence variants affecting eosinophil numbers associate with asthma and myocardial infarction. Nat Genet 41(3):342–347

    Article  CAS  PubMed  Google Scholar 

  13. Falcone C, Minoretti P, D’Angelo A, Buzzi MP, Coen E, Emanuele E, Aldeghi A, Olivieri V, Geroldi D (2006) Markers of eosinophilic inflammation and risk prediction in patients with coronary artery disease. Eur J Clin Invest 36(4):211–217

    Article  CAS  PubMed  Google Scholar 

  14. American Diabetes Association (2009) Diagnosis and classification of diabetes mellitus. Diabetes Care 32:S62–S67

    Article  PubMed Central  Google Scholar 

  15. Poggio ED, Wang X, Greene T, Van Lente F, Hall PM (2005) Performance of the modification of diet in renal disease and Cockcroft-Gault equations in the estimation of GFR in health and in chronic kidney disease. J Am Soc Nephrol 16(2):459–466

    Article  PubMed  Google Scholar 

  16. De Luca G, Secco GG, Santagostino M, Venegoni L, Iorio S, Cassetti E, Verdoia M, Coppo L, Di Mario C, Bellomo G, Marino P, Novara Atherosclerosis Study Group (NAS) (2012) Uric acid does not affect the prevalence and extent of coronary artery disease. Results from a prospective study. Nutr Metab Cardiovasc Dis 22:426–433

    Article  PubMed  Google Scholar 

  17. De Luca G, van ‘t Hof AW, Ottervanger JP, Hoorntje JC, Gosselink AT, Dambrink JH, de Boer MJ, Suryapranata H (2005) Ageing, impaired myocardial perfusion, and mortality in patients with ST-segment elevation myocardial infarction treated by primary angioplasty. Eur Heart J 26:662–666

    Article  PubMed  Google Scholar 

  18. De Luca G, Santagostino M, Secco GG, Cassetti E, Giuliani L, Franchi E, Coppo L, Iorio S, Venegoni L, Rondano E, Dell’Era G, Rizzo C, Pergolini P, Monaco F, Bellomo G, Marino P (2009) Mean platelet volume and the extent of coronary artery disease: results from a large prospective study. Atherosclerosis 206:292–297

    Article  PubMed  Google Scholar 

  19. De Luca G, Bellandi F, Huber K, Noc M, Petronio AS, Arntz HR, Maioli M, Gabriel HM, Zorman S, de Carlo M, Rakowski T, Gyongyosi M, Dudek D (2011) Early glycoprotein IIb–IIIa inhibitors in primary angioplasty–abciximab long-term results (EGYPT-ALT) cooperation: individual patient’s data meta-analysis. J Thromb Haemost 9:2361–2370

    Article  Google Scholar 

  20. De Luca G, Verdoia M, Suryapranata H (2012) Benefits from intracoronary as compared to intravenous abciximab administration for STEMI patients undergoing primary angioplasty: a meta-analysis of 8 randomized trials. Atherosclerosis 222:426–433

    Article  PubMed  Google Scholar 

  21. De Luca G, Ernst N, van ‘t Hof AW, Ottervanger JP, Hoorntje JC, Gosselink AT, Dambrink JH, de Boer MJ, Suryapranata H (2006) Predictors and clinical implications of early reinfarction after primary angioplasty for ST-segment elevation myocardial infarction. Am Heart J 151:1256–1259

    Article  PubMed  Google Scholar 

  22. De Luca G, Ernst N, Suryapranata H, Ottervanger JP, Hoorntje JC, Gosselink AT, Dambrink JH, de Boer MJ, van ‘t Hof AW (2005) Relation of interhospital delay and mortality in patients with ST-segment elevation myocardial infarction transferred for primary coronary angioplasty. Am J Cardiol 95:1361–1363

    Article  PubMed  Google Scholar 

  23. Koenig W (2013) High-sensitivity C-reactive protein and atherosclerotic disease: from improved risk prediction to risk-guided therapy. Int J Cardiol 168(6):5126–5134

    Article  PubMed  Google Scholar 

  24. Madjid M, Casscells SW, Willerson JT (2007) Biomarkers of inflammation as surrogate markers in detection of vulnerable plaques and vulnerable patients. Cardiovascular medicine, 3rd edn. Springer-Verlag London Limited, London, pp 641–651

    Google Scholar 

  25. Folsom AR, Chambless LE, Ballantyne CM, Coresh J, Heiss G, Wu KK et al (2006) An assessment of incremental coronary risk prediction using C-reactive protein and other novel risk markers: the atherosclerosis risk in communities study. Arch Intern Med 166(13):1368–1373

    Article  CAS  PubMed  Google Scholar 

  26. Ridker PM (2001) High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation 103(13):1813–1818

    Article  CAS  PubMed  Google Scholar 

  27. Thompson A, Gao P, Orfei L et al (2010) Lipoprotein-associated phospholipase A(2) and risk of coronary disease, stroke, and mortality: collaborative analysis of 32 prospective studies. Lancet 375(9725):1536–1544

    Article  CAS  PubMed  Google Scholar 

  28. Danesh J, Kaptoge S, Mann AG et al (2008) Long-term interleukin-6 levels and subsequent risk of coronary heart disease: two newprospective studies and a systematic review. PLoS Med 5(4):e78

    Article  PubMed Central  PubMed  Google Scholar 

  29. Shah N, Parikh V, Patel N, Patel N, Badheka A, Deshmukh A, Rathod A, Lafferty J (2014) Neutrophil lymphocyte ratio significantly improves the Framingham risk score in prediction of coronary heart disease mortality: insights from the National Health and Nutrition Examination Survey-III. Int J Cardiol 15:390–397

    Article  Google Scholar 

  30. Fauci AS, Harley JB, Roberts WC, Ferrans VJ, Gralnick HR, Bjornson BH (1982) The idiopathic hypereosinophilic syndrome. Clinical, pathophysiologic, and therapeutic considerations. Ann Intern Med 97:78–92

    Article  CAS  PubMed  Google Scholar 

  31. Chihara J, Yamamoto T, Kurachi D, Kakazu T, Higashimoto I, Nakajima S (1995) Possible release of eosinophil granule proteins in response to signaling from intercellular adhesion molecule-1 and its ligands. Int Arch Allergy Immunol 108(Suppl 1):52–54

    Article  CAS  PubMed  Google Scholar 

  32. Hou L, Lloyd-Jones DM, Ning H, Huffman MD, Fornage M, He K, Zhang X, Jacobs DR, Goff DC, Sidney S, Carr JJ, Liu K (2013) White blood cell count in young adulthood and coronary artery calcification in early middle age: coronary artery risk development in young adults (CARDIA) study. Eur J Epidemiol 28:735–742

    Article  PubMed  Google Scholar 

  33. Margolis KL, Manson JE, Greenland P, Rodabough RJ, Bray PF, Safford M et al (2005) Leukocyte count as a predictor of cardiovascular events and mortality in postmenopausal women: the Women’s Health Initiative Observational Study. Arch Intern Med 165:500–508

    Article  PubMed  Google Scholar 

  34. Toor IS, Jaumdally R, Lip GY, Millane T, Varma C (2012) Eosinophil count predicts mortality following percutaneous coronary intervention. Thromb Res 130:607–611

    Article  CAS  PubMed  Google Scholar 

  35. Matsumura T, Taketa K, Motoshima H, Senokuchi T, Ishii N, Kinoshita H, Fukuda K, Yamada S, Kukidome D, Kondo T, Hisada A, Katoh T, Shimoda S, Nishikawa T, Araki E (2013) Association between circulating leukocyte subtype counts and carotid intima-media thickness in Japanese subjects with type 2 diabetes. Cardiovasc Diabetol 12:177–181

    Article  PubMed Central  PubMed  Google Scholar 

  36. Gyurko R, Siqueira CC, Caldon N, Gao L, Kantarci A, Van Dyke TE (2006) Chronic hyperglycemia predisposes to exaggerated inflammatory response and leukocyte dysfunction in Akita mice. J Immunol 177(10):7250–7256

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  37. Erdogan O, Gul C, Altun A, Ozbay G (2003) Increased immunoglobulin E response in acute coronary syndromes. Angiology 54(1):73–79

    Article  PubMed  Google Scholar 

  38. Hansson GK (2005) Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med 352(16):1685–1695

    Article  CAS  PubMed  Google Scholar 

  39. Shin SW, Park JS, Park CS (2013) Elevation of eosinophil-derived neurotoxin in plasma of the subjects with aspirin-exacerbated respiratory disease: a possible peripheral blood protein biomarker. PLoS One 8(6):e66644

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  40. Zeki AA, Oldham J, Wilson M, Fortenko O, Goyal V, Last M, Last A, Patel A, Last JA, Kenyon NJ (2013) Statin use and asthma control in patients with severe asthma. BMJ Open 3(8):e003314

    Article  PubMed Central  PubMed  Google Scholar 

  41. Lokhandwala T, West-Strum D, Banahan BF et al (2012) Do statins improve outcomes in patients with asthma on inhaled corticosteroid therapy? A retrospective cohort analysis. BMJ 2:1–8

    Google Scholar 

  42. Chung CP, Oeser A, Raggi P, Gebretsadik T, Shintani AK, Sokka T, Pincus T, Avalos I, Stein CM (2005) Increased coronary-artery atherosclerosis in rheumatoid arthritis: relationship to disease duration and cardiovascular risk factors. Arthritis Rheum 52(10):3045–3053

    Article  PubMed  Google Scholar 

  43. Kim DJ, Noh JH, Lee BW, Choi YH, Chung JH, Min YK, Lee MS, Lee MK, Kim KW (2008) The associations of total and differential white blood cell counts with obesity, hypertension, dyslipidemia and glucose intolerance in a Korean population. J Korean Med Sci 23(2):193–198

    Article  PubMed Central  PubMed  Google Scholar 

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Correspondence to Giuseppe De Luca.

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On behalf of the Novara Atherosclerosis Study Group (NAS).

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Verdoia, M., Schaffer, A., Cassetti, E. et al. Absolute eosinophils count and the extent of coronary artery disease: a single centre cohort study. J Thromb Thrombolysis 39, 459–466 (2015). https://doi.org/10.1007/s11239-014-1120-3

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