TY - JOUR
TI - Low lymphocyte ratio as a novel prognostic factor in acute heart failure: Results from the Pre-RELAX-AHF study
AU - Milo-Cotter, O.
AU - Teerlink, J.R.
AU - Metra, M.
AU - Felker, G.M.
AU - Ponikowski, P.
AU - Voors, A.A.
AU - Edwards, C.
AU - Weatherley, B.D.
AU - Greenberg, B.
AU - Filippatos, G.
AU - Unemori, E.
AU - Teichman, S.L.
AU - Cotter, G.
JO - Cardiology (Switzerland)
PY - 2011
VL - 117
TODO - 3
SP - 190-196
PB - 
SN - null
TODO - 10.1159/000321416
TODO - brain natriuretic peptide;  glucose;  placebo;  relaxin, acute heart failure;  aged;  article;  controlled study;  dyspnea;  female;  hospitalization;  human;  lymphocyte count;  major clinical study;  male;  peripheral vascular disease;  priority journal;  prognosis;  systolic blood pressure, Aged;  Female;  Heart Failure;  Humans;  Infusions, Intravenous;  Lymphocyte Count;  Male;  Middle Aged;  Prognosis;  Relaxin
TODO - Background: Previous studies have suggested that a lower lymphocyte ratio (Ly%) in the white blood cell (WBC) differential count is related to worse outcomes in patients with acute heart failure (AHF) and other cardiovascular disorders. Methods: In the Pre-RELAX-AHF study, 234 patients with AHF, systolic blood pressure >125 mm Hg and brain natriuretic peptide ≥350 pg/ml or equivalent were randomized to 1 of 4 intravenous doses of relaxin or placebo and followed up for 6 months following randomization. Complete blood count and differential were performed by a central laboratory at baseline and then daily to day 5 and on day 14. Results: The WBC count by itself was not associated with measures of disease severity or outcome, and patients with Ly% <13% had similar baseline characteristics to patients with Ly% >13%, except for a higher baseline WBC count, elevated baseline glucose, older age and higher rates of peripheral vascular disease. However, patients with Ly% <13% had less improvement of dyspnea, greater worsening of heart failure, longer length of initial hospital stay and fewer days alive and out of hospital. Statistical significance was reached for all-cause death by days 60 and 180 (hazard ratio = 1.11 per percent decrease, 95% confidence interval 1.03-1.19; p = 0.0048). Conclusions: Despite no association with any baseline characteristic known to strongly predict outcome in AHF, low Ly% is associated with less symptom relief and worse in-hospital and postdischarge clinical outcomes. Copyright © 2010 S. Karger AG, Basel.
ER -