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Association between leukocyte count and the presence and extent of coronary atherosclerosis as determined by coronary arteriography
Authors:John B Kostis  Darya Turkevich  John Sharp
Institution:From the Division of Cardiovascular Diseases, Department of Medicine, University of Medicine and Dentistry of New Jersey-Rutgers Medical School, New Brunswick, New Jersey USA
Abstract:Angiographic evidence of coronary artery disease (CAD) was correlated with leukocyte count (WBC), red cell count (RBC), cigarette smoking, age, sex, and cholesterol and triglyceride concentrations in 573 patients who underwent coronary arteriography and who did not have evidence of infection or recent myocardial infarction. Smokers had a higher WBC (7,449 ± 1,964leukocytes/mm3 vs 6,533 ± 1,557, p = 0.0001) and RBC (4.921 × 106 ± 0.491 × 106 erythrocytes/mm3 vs 4.753 × 106 ± 0.480 × 106 p = 0.0001) than nonsmokers. Patients with CAD had a higher WBC (7,280 ± 1,926 vs 6,664 ± 1,700, p = 0.0005) and RBC (4.903 × 106 ± 0.488 vs 4.777 × 106 ± 0.485 × 106, p = 0.0062) than those with normal coronary arteriograms. A positive correlation between WBC and the severity of CAD (sum of arterial diameter narrowing) was noted (r = 0.16, p = 0.0001). Multiple regression showed an independent contribution of WBC in predicting severity of CAD (F = 9.26, p = 0.0025), after accounting for the effects of age, sex, serum cholesterol and triglyceride levels. When smoking was entered into the equation, the contribution of WBC in predicting the severity of angiographic CAD became weaker (F = 4.46, p = 0.035). Similar relations were seen when only smokers were analyzed and when patients with history of remote myocardial infarction were excluded. In nonsmokers these associations became either insignificant or much weaker. Thus, the relation of WBC, and RBC with CAD is mainly due to the elevation of WBC and RBC and the increase of CAD risk induced by cigarette smoking.
Keywords:Address for reprints: John B  Kostis  MD  Division of Cardiovascular Diseases  Department of Medicine  University of Medicine and Dentistry of New Jersey-Rutgers Medical School  Academic Health Science Center  CN19 New Brunswick  New Jersey 08901  
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