Frontiers in Endocrinology (Apr 2023)

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

DOI
https://doi.org/10.3389/fendo.2023.1129633
Journal volume & issue
Vol. 14

Abstract

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BackgroundInflammatory 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).MethodsA 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.ResultsDuring 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).ConclusionThis study suggests that stratification of patients with elevated ANC and T2D could provide prognostic information for CAD patients undergoing PCI.

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