Association of total white cell count with mortality and major adverse events in patients with peripheral arterial disease: a systematic review

Martin, D., Wallace, D., Crowe, M., Rush, C., Tosenovsky, P., and Golledge, J. (2014) Association of total white cell count with mortality and major adverse events in patients with peripheral arterial disease: a systematic review. European Journal of Vascular and Endovascular Surgery, 47 (4). pp. 422-432.

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Abstract

Objectives: Peripheral arterial disease (PAD) is principally caused by atherosclerosis, an established inflammatory disease. Total white cell count (TWCC) is a marker of inflammation and has been associated with outcomes for patients with inflammatory diseases. The aim of this systematic review was to assess the association of TWCC with mortality and major adverse events (MAEs) in PAD patients.

Methods: Studies investigating the association of TWCC with outcome in patients with PAD were identified by a literature search using the Medline and Cochrane databases. To be eligible for inclusion, studies needed to investigate the association of TWCC with mortality or a composite endpoint that included mortality in patients with PAD. Studies were excluded when the primary focus was carotid artery disease, aortic aneurysmal disease, intracranial vascular disease, or rheumatoid arthritis and treatment with chemotherapy or transplantation of stem cells. Secondary searching of reference lists and relevant reviews was performed.

Results: Ten studies including 8,490 patients with PAD met the inclusion criteria. All studies investigated more than 100 patients with four studies assessing more than 1,000 patients. Study quality varied with well-established risk factors of outcome such as age, smoking, diabetes, and the ankle brachial index being adjusted for inconsistently. The study populations were also disparate. Few studies reported relative risk and 95% confidence intervals for the association of TWCC with mortality or MAE. TWCC was positively and significantly associated with death alone in four of five studies investigating 3,387 patients. TWCC was positively and significantly associated with MAE in five of six studies investigating a total of 6,846 patients.

Conclusions: Current evidence suggests a positive association of TWCC with mortality and MAEs in patients with PAD. Further well-designed prospective studies are required with high-quality analysis and more complete reporting of outcomes.rting of outcomes.

Item ID: 33282
Item Type: Article (Research - C1)
ISSN: 1532-2165
Keywords: peripheral arterial disease, white cell count, inflammation, prognosis, mortality
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Additional Information:

A version of this publication was included as Chapter 3 of the following PhD thesis: Martin, David Terence (2018) Circulating cells associated with cardiovascular outcomes in peripheral arterial occlusive disease. PhD thesis, James Cook University, which is available Open Access in ResearchOnline@JCU. Please see the Related URLs for access.

Funders: Queensland Tropical Health Alliance (QTHA), Queensland Government, National Health and Medical Research Council (NHMRC)
Date Deposited: 04 Jun 2014 01:40
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl Cardiovascular Diseases) @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 100%
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