PMID- 9443426
OWN - NLM
STAT- MEDLINE
DCOM- 19980217
LR  - 20220331
IS  - 0009-7322 (Print)
IS  - 0009-7322 (Linking)
VI  - 97
IP  - 1
DP  - 1998 Jan 6-13
TI  - Predictive power of the relative lymphocyte concentration in patients with 
      advanced heart failure.
PG  - 19-22
AB  - BACKGROUND: The physiological stress suffered by patients with heart failure 
      results in an increased production of cortisol and a shift in the leukocyte 
      differential toward a decreased percentage of lymphocytes (%L). The purpose of 
      this study was to determine the prognostic significance of a low %L in advanced 
      heart failure. METHODS AND RESULTS: Patients evaluated in our cardiac 
      transplantation clinic between April 1988 and July 1995 were retrospectively 
      reviewed (n=263). Fifty-two patients were excluded because they had recent 
      trauma, infection, surgery, myocardial infarction, corticosteroid use, or history 
      of malignancy. In the remaining 211 patients, we used Cox proportional hazards 
      analysis to examine the association between survival and transplant-free survival 
      with baseline variables. Univariate analysis showed a significant association 
      between time to death and %L (P=.004), New York Heart Association (NYHA) class 
      (P=.002), and maximal oxygen uptake (P=.05). Univariate analysis of the end point 
      of survival free from transplantation yielded similar results. One- and 4-year 
      survival rates for patients with a low %L (<20.3%) were 78% and 34% compared with 
      90% and 73% for those with a normal %L. Multivariate analysis showed NYHA class 
      (P<.008) and %L (P<.01) were independent predictors of survival and survival free 
      from cardiac transplantation. CONCLUSIONS: The relative lymphocyte concentration 
      is an inexpensive, readily available, simple prognostic marker in patients with 
      symptomatic heart failure who do not have recent trauma, infection, surgery, 
      myocardial infarction, corticosteroid use, or history of malignancy. It could be 
      incorporated into clinical models to predict patient outcome and to aid in the 
      selection of patients for cardiac transplantation.
FAU - Ommen, S R
AU  - Ommen SR
AD  - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn., USA.
FAU - Hodge, D O
AU  - Hodge DO
FAU - Rodeheffer, R J
AU  - Rodeheffer RJ
FAU - McGregor, C G
AU  - McGregor CG
FAU - Thomson, S P
AU  - Thomson SP
FAU - Gibbons, R J
AU  - Gibbons RJ
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
SB  - IM
CIN - Circulation. 1998 Oct 13;98(15):1590. PMID: 9769318
MH  - Analysis of Variance
MH  - Animals
MH  - Female
MH  - Heart Failure/*blood/*mortality
MH  - Humans
MH  - *Lymphocyte Count
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Survival Rate
EDAT- 1998/01/27 00:00
MHDA- 1998/01/27 00:01
CRDT- 1998/01/27 00:00
PHST- 1998/01/27 00:00 [pubmed]
PHST- 1998/01/27 00:01 [medline]
PHST- 1998/01/27 00:00 [entrez]
AID - 10.1161/01.cir.97.1.19 [doi]
PST - ppublish
SO  - Circulation. 1998 Jan 6-13;97(1):19-22. doi: 10.1161/01.cir.97.1.19.