Total white blood cell count is associated with the presence, severity and extent of coronary atherosclerosis detected by dual-source multislice computed tomographic coronary angiography

Abstract

BACKGROUND: Total white blood cell (WBC) count has been consistently shown to be an
independent risk factor and predictor for future cardiovascular outcomes, regardless of disease
status in coronary artery disease (CAD). The purpose of this study is to evaluate the relationship
between total WBC count and the presence, severity and extent of coronary atherosclerosis
detected in subjects undergoing multislice computed tomographic (MSCT) coronary angiography
for suspected CAD.

METHODS: A total of 817 patients were enrolled in this cross-sectional study. Non-significant
coronary plaque was defined as lesions causing £ 50% luminal narrowing, and significant
coronary plaque was defined as lesions causing > 50% luminal narrowing. For each segment,
coronary atherosclerotic lesions were categorized as none, calcified, non-calcified and mixed.
All images were interpreted immediately after scanning by an experienced radiologist.

RESULTS: An association between hypertension, diabetes mellitus, age, gender, hyperlipidemia,
smoking, total WBC counts and coronary atherosclerosis was found when patients were
grouped into two categories according to the presence of coronary atherosclerosis (p < 0.05).
Although plaque morphology was not associated with total WBC counts, the extent of coronary
atherosclerosis was increased with higher total WBC quartiles (p = 0.006). Patients with
critical luminal stenosis had higher levels of total WBC counts when compared to patients with
non-critical luminal narrowing (7,982 ± 2,287 vs 7,184 ± 1,944, p < 0.05).

CONCLUSIONS: Our study demonstrated that total WBC counts play an important role in
inflammation and are associated with the presence, severity and extent of coronary atherosclerosis
detected by MSCT. Further studies are needed to assess the true impact of WBC counts
on coronary atherosclerosis, and to promote its use in predicting CAD. (Cardiol J 2011; 18, 4:
371–377)