Association of White Blood Cell Count and Differential with the Incidence of Atrial Fibrillation: The Atherosclerosis Risk in Communities (ARIC) Study.
Association of White Blood Cell Count and Differential with the Incidence of Atrial Fibrillation: The Atherosclerosis Risk in Communities (ARIC) Study.
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DOI：
10.1371/journal.pone.0136219
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Alonso A
中科院分区：
文献类型：
--
作者：
Misialek JR;Bekwelem W;Chen LY;Loehr LR;Agarwal SK;Soliman EZ;Norby FL;Alonso A
虽然炎症参与了房颤（AF）的发生，但在大规模队列中，尚未通过长期随访彻底检查白色血细胞（WBC）计数和分类与AF的相关性。我们研究了来自社区动脉粥样硬化风险（ARIC）研究的14，500名男性和女性（25%黑人，55%女性，平均年龄54岁）基线（1987-89）无AF，ARIC研究是美国的一项基于社区的队列研究。通过研究心电图、出院记录和死亡证明确定了2010年的房颤事件病例。多变量考克斯比例风险回归用于估计与WBC计数和分类相关的AF的风险比（HR）和95%置信区间（CI）。在整个队列的中位随访时间为21.5年期间，1928名参与者发生AF。较高的总WBC计数与较高的AF风险相关，与AF风险因素和潜在混杂因素无关（HR 1.09，95% CI 1.04-1.15/1-标准差[SD]增加）。较高的中性粒细胞和单核细胞计数与AF风险呈正相关，而淋巴细胞计数与AF呈负相关（多变量校正HR分别为1.16，95% CI 1.09-1.23; 1.05，95% CI 1.00-1.11; 0.91，95% CI 0.86-0.97/1-SD）。嗜酸性粒细胞或嗜碱性粒细胞与AF之间无显著相关性。高总WBC、中性粒细胞和单核细胞计数均与较高的AF风险相关，而淋巴细胞计数与AF风险呈负相关。全身炎症可能是这种关联的基础，需要进一步研究预防AF的策略。
Although inflammation is involved in the development of atrial fibrillation (AF), the association of white blood cell (WBC) count and differential with AF has not been thoroughly examined in large cohorts with extended follow-up. We studied 14,500 men and women (25% blacks, 55% women, mean age 54) free of AF at baseline (1987–89) from the Atherosclerosis Risk in Communities (ARIC) study, a community-based cohort in the United States. Incident AF cases through 2010 were identified from study electrocardiograms, hospital discharge records and death certificates. Multivariable Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for AF associated with WBC count and differential. Over a median follow-up time of 21.5 years for the entire cohort, 1928 participants had incident AF. Higher total WBC count was associated with higher AF risk independent of AF risk factors and potential confounders (HR 1.09, 95% CI 1.04–1.15 per 1-standard deviation [SD] increase). Higher neutrophil and monocyte counts were positively associated with AF risk, while an inverse association was identified between lymphocyte count and AF (multivariable adjusted HRs 1.16, 95% CI 1.09–1.23; 1.05, 95% CI 1.00–1.11; 0.91, 95% CI 0.86–0.97 per 1-SD, respectively). No significant association was identified between eosinophils or basophils and AF. High total WBC, neutrophil, and monocyte counts were each associated with higher AF risk while lymphocyte count was inversely associated with AF risk. Systemic inflammation may underlie this association and requires further investigation for strategies to prevent AF.