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Routinely measured hematological parameters and prediction of recurrent vascular events in patients with clinically manifest vascular disease.


ABSTRACT:

Background and aims

The predictive value of traditional risk factors for vascular events in patients with manifest vascular disease is limited, underscoring the need for novel biomarkers to improve risk stratification. Since hematological parameters are routinely assessed in clinical practice, they are readily available candidates.

Methods

We used data from 3,922 vascular patients, who participated in the Second Manifestations of ARTerial Disease (SMART) study. We first investigated associations between recurrent vascular events and 22 hematological parameters, obtained from the Utrecht Patient Oriented Database (UPOD), and then assessed whether parameters associated with outcome improved risk prediction.

Results

After adjustment for all SMART risk score (SRS) variables, lymphocyte %, neutrophil count, neutrophil % and red cell distribution width (RDW) were significantly associated with vascular events. When individually added to the SRS, lymphocyte % improved prediction of recurrent vascular events with a continuous net reclassification improvement (cNRI) of 17.4% [95% CI: 2.1, 32.1%] and an increase in c-statistic of 0.011 [0.000, 0.022]. The combination of lymphocyte % and neutrophil count resulted in a cNRI of 22.2% [3.2, 33.4%] and improved c-statistic by 0.011 [95% CI: 0.000, 0.022]. Lymphocyte % and RDW yielded a cNRI of 18.7% [3.3, 31.9%] and improved c-statistic by 0.016 [0.004, 0.028]. However, the addition of hematological parameters only modestly increased risk estimates for patients with an event during follow-up.

Conclusions

Several hematological parameters were independently associated with recurrent vascular events. Lymphocyte % alone and in combination with other parameters enhanced discrimination and reclassification. However, the incremental value for patients with a recurrent event was limited.

SUBMITTER: Kofink D 

PROVIDER: S-EPMC6128486 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Routinely measured hematological parameters and prediction of recurrent vascular events in patients with clinically manifest vascular disease.

Kofink Daniel D   Muller Steven A SA   Patel Riyaz S RS   Dorresteijn Jannick A N JAN   Berkelmans Gijs F N GFN   de Groot Mark C H MCH   van Solinge Wouter W WW   Haitjema Saskia S   Leiner Tim T   Visseren Frank L J FLJ   Hoefer Imo E IE   Asselbergs Folkert W FW  

PloS one 20180907 9


<h4>Background and aims</h4>The predictive value of traditional risk factors for vascular events in patients with manifest vascular disease is limited, underscoring the need for novel biomarkers to improve risk stratification. Since hematological parameters are routinely assessed in clinical practice, they are readily available candidates.<h4>Methods</h4>We used data from 3,922 vascular patients, who participated in the Second Manifestations of ARTerial Disease (SMART) study. We first investigat  ...[more]

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