Prognostic implication of monocytes in atrial fibrillation: The West Birmingham Atrial Fibrillation Project

• Published in: PloS one 2018-07, Vol.13 (7), p.e0200373-e0200373
• Main Authors: Shahid, Farhan, Rahmat, Nur A, Lip, Gregory Y H, Shantsila, Eduard
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Atherosclerosis; Biology and Life Sciences; Bleeding; Blood clots; Cardiac arrhythmia; Cardiac patients; Cardiology; Cardiovascular disease; Cardiovascular diseases; Care and treatment; Confidence intervals; Death; Dendritic cells; Embolism; Embolisms; Fibrillation; Genetic aspects; Health aspects; Health risk assessment; Heart attacks; Heart failure; Hypertension; Inflammation; Medical prognosis; Medicine and Health Sciences; Monocytes; Mortality; Patients; Prognosis; Quartiles; Statistical analysis; Stroke; Studies; Thrombosis; Values
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0200373

High monocyte counts are related to adverse outcomes in cardiovascular disease. Their role in prognostication in patients with atrial fibrillation (AF) is unknown. We investigated whether monocyte counts are useful as a marker of prognosis in patients with AF. Monocyte counts were obtained from blood samples in 881 AF patients. Study outcomes were (i) all-cause death; (ii) major adverse cardiovascular events; (iii) stroke, TIA or other systemic embolism (SSE); and (iv) major bleeding. Median follow up was 7.2 years; 44% of patients died, 48% developed MACE; 9% had SSE and 5% had major bleeding. On Cox regression, after adjustment for CHA2DS2-VASc score, the highest quartile of monocyte counts (i.e., ≥580 μL vs. other quartiles) was associated with increased risk of death (hazard ratio [HR] 1.64, 95% confidence interval [CI] 1.31-2.05, p