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European Heart Journal 2004 25(15):1287-1292; doi:10.1016/j.ehj.2004.05.002
Copyright © 2004 by the European Society of Cardiology.
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Clinical research

Associations between differential leucocyte count and incident coronary heart disease: 1764 incident cases from seven prospective studies of 30 374 individuals

Jeremy G Wheelera, Michael E Mussolinob, Richard F Gillumb and John Danesha,*

a Department of Public Health and Primary Care, University of Cambridge, Strangeways Site, Wort's Causeway, Cambridge CB1 8RN, UK
b Centers for Disease Control and Prevention, 3311 Toledo Road, Hyattsville, MD, USA

E-mail address: jgw27{at}cam.ac.uk

* Corresponding author. Tel.: +44-1223-741310; fax: +44-1223-741339

Received 28 November 2003; revised 19 April 2004; accepted 5 May 2004 See page 1271 for the editorial comment on this article.1

Abstract

Aims We aimed to assess potential associations between different leucocyte components and coronary heart disease (CHD) in a prospective cohort study, and to put these findings in context of other relevant prospective studies in a meta-analysis.

Methods and results We report data on differential leucocyte count and CHD derived from the first National Health and Nutrition Examination Survey (NHANES I) and the NHANES 1 Epidemiologic Follow-up Study (NHEFS) involving 4625 individuals followed, on average, for 18 years. The NHEFS involved 914 incident CHD cases and yielded an adjusted risk ratio of 1.09 (0.93–1.29) comparing individuals with neutrophil counts in the top third versus those in the bottom third of the population. In a meta-analysis involving the NHEFS and four other studies comprising a total of 1764 incident CHD cases, the association of CHD with neutrophil counts was somewhat stronger than those with other specific leucocyte components (combined risk ratio=1.33 [1.17–1.50]) but there was substantial heterogeneity between the separate studies (, ).

Conclusions Although the present synthesis provides the most comprehensive assessment so far of specific leucocyte components in CHD, additional prospective data will be needed to resolve whether neutrophil counts are much stronger predictors of CHD risk than other components.

Key Words: Leucocytes • Coronary disease • Meta-analysis


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