Characteristics of peripheral blood cells are independently related to major adverse cardiovascular events after carotid endarterectomy
Overmars, L. Malin; Mekke, Joost M.; van Solinge, Wouter W.; De Jager, Saskia C.A.; Hulsbergen-Veelken, Cornelia A.R.; Hoefer, Imo E.; de Kleijn, Dominique P.V.; de Borst, Gert J.; van der Laan, Sander W.; Haitjema, Saskia
(2023) Atherosclerosis Plus, volume 52, pp. 32 - 40
(Article)
Abstract
BACKGROUND AND AIMS: Patients who underwent carotid endarterectomy (CEA) still have a residual risk of 13% of developing a major adverse cardiovascular event (MACE) within 3 years. Inflammatory processes leading up to MACE are not fully understood. Therefore, we examined blood cell characteristics (BCCs), possibly reflecting inflammatory processes, in relation
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to MACE to identify BCCs that may contribute to an increased risk. METHODS: We analyzed 75 pretreatment BCCs from the Sapphire analyzer, and clinical data from the Athero-Express biobank in relation to MACE after CEA using Random Survival Forests, and a Generalized Additive Survival Model. To understand biological mechanisms, we related the identified variables to intraplaque hemorrhage (IPH). RESULTS: Of 783 patients, 97 (12%) developed MACE within 3 years after CEA. Red blood cell distribution width (RDW) (HR 1.23 [1.02, 1.68], p = 0.022), CV of lymphocyte size (LACV) (HR 0.78 [0.63, 0.99], p = 0.043), neutrophil complexity of the intracellular structure (NIMN) (HR 0.80 [0.64, 0.98], p = 0.033), mean neutrophil size (NAMN) (HR 0.67 [0.55, 0.83], p < 0.001), mean corpuscular volume (MCV) (HR 1.35 [1.09, 1.66], p = 0.005), eGFR (HR 0.65 [0.52, 0.80], p < 0.001); and HDL-cholesterol (HR 0.62 [0.45, 0.85], p = 0.003) were related to MACE. NAMN was related to IPH (OR 0.83 [0.71-0.98], p = 0.02). CONCLUSIONS: This is the first study to present a higher RDW and MCV and lower LACV, NIMN and NAMN as biomarkers reflecting inflammatory processes that may contribute to an increased risk of MACE after CEA.
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Keywords: Blood cell characteristics, Carotid endarterectomy, Hematology, Inflammation, Intraplaque hemorrhage, Machine learning, Major adverse cardiovascular events, Routine care data, Internal Medicine, Cardiology and Cardiovascular Medicine, Journal Article
ISSN: 2667-0909
Publisher: Elsevier Ireland Ltd
Note: Funding Information: This work was supported by the Netherlands Cardiovascular Research Initiative : an initiative with support of the Dutch Heart Foundation ( CVON-GENIUS-2 to GP and SWvdL & CVON2017-5 Persuasive to DdK). We are thankful for the support of the ERA-CVD program ‘druggable-MI-targets ’ (grant number: 01KL1802 , SWvdL ), the EU H2020 TO_AITION (grant number: 848146 , SWvdL ), EU H2020 Taxinomisis (grant number 755320 GP , GJB , DdK ), and the Leducq Fondation ‘PlaqOmics’ ( GP , SWvdL ). JMM was funded on a Dutch Heart Foundation Dekker grant (grant 2017T067 ). Publisher Copyright: © 2023 The Authors
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