Full blood count as potential predictor of outcomes in patients undergoing cardiac resynchronization therapy.
Nikolaos PapageorgiouDebbie FalconerAdam IoannouTanakal WongwarawipatSergio BarraDimitris TousoulisWei Yao LimFakhar Z KhanSyed AhsanAmal MuthumalaRoss J HunterMalcolm FinlayAntonio CretaEdward RowlandMartin LoweOliver R SegalRichard J SchillingPier D LambiaseAnthony W ChowRui Andre ProvidenciaPublished in: Scientific reports (2019)
Almost a third of patients fulfilling current guidelines criteria have suboptimal responses following cardiac resynchronization therapy (CRT). Circulating biomarkers may help identify these patients. We aimed to assess the predictive role of full blood count (FBC) parameters in prognosis of heart failure (HF) patients undergoing CRT device implantation. We enrolled 612 consecutive CRT patients and FBC was measured within 24 hours prior to implantation. The follow-up period was a median of 1652 days (IQR: 837-2612). The study endpoints were i) composite of all-cause mortality or transplant, and ii) reverse left ventricular (LV) remodeling. On multivariate analysis [hazard ratio (HR), 95% confidence interval (CI)] only red cell count (RCC) (p = 0.004), red cell distribution width (RDW) (p < 0.001), percentage of lymphocytes (p = 0.03) and platelet count (p < 0.001) predicted all-cause mortality. Interestingly, RDW (p = 0.004) and platelet count (p = 0.008) were independent predictors of reverse LV remodeling. This is the first powered single-centre study to demonstrate that RDW and platelet count are independent predictors of long-term all-cause mortality and/or heart transplant in CRT patients. Further studies, on the role of these parameters in enhancing patient selection for CRT implantation should be conducted to confirm our findings.
Keyphrases
- cardiac resynchronization therapy
- heart failure
- left ventricular
- end stage renal disease
- patients undergoing
- ejection fraction
- newly diagnosed
- peripheral blood
- peritoneal dialysis
- prognostic factors
- single cell
- risk assessment
- acute myocardial infarction
- adipose tissue
- acute coronary syndrome
- skeletal muscle
- coronary artery disease
- aortic valve
- metabolic syndrome
- mitral valve
- transcatheter aortic valve replacement
- clinical practice