Annemarie M den Harder1, Pim A de Jong2, Mark C H de Groot3, Jelmer M Wolterink4, Ricardo P J Budde5, Ivana Iŝgum4, Wouter W van Solinge3, Maarten J Ten Berg3, Esther Lutgens6, Wouter B Veldhuis2, Saskia Haitjema3, Imo E Hoefer4, Tim Leiner2. 1. Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands. Electronic address: a.m.denharder@umcutrecht.nl. 2. Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands. 3. Department of Clinical Chemistry and Hematology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands. 4. Image Sciences Institute, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands. 5. Department of Radiology, Erasmus Medical Center, Rotterdam, the Netherlands. 6. Department of Medical Biochemistry, Academic Medical Center, Amsterdam, the Netherlands; Institute for Cardiovascular Prevention, Ludwig-Maximilians-University, Munich, Germany.
Abstract
BACKGROUND AND AIMS: We aimed to improve the understanding of potential associations between commonly available hematological biomarkers and the coronary artery calcification (CAC) score, which may help unravel the pathophysiology of coronary calcifications and subclinical coronary artery disease. METHODS: A cross-sectional study was performed within the Utrecht Patient Oriented Database (UPOD). Patients with suspected or known coronary artery disease who underwent CT CAC scoring as well as standard hematology analysis that was part of routine clinical care (within 3 months of CT acquisition) were included. Complete hematology datasets were extracted from hematology analyzers. Linear regression adjusted for potential confounders was used to assess if hematological biomarkers were related to the CAC score. RESULTS: In total, 1504 patients were included, of whom 43% (n = 647) had a CAC score of 0. Mean age (±SD) was 53 ± 13 years, and 34% of patients were women. Red blood cell distribution width (RDW, β = 0.20 [0.05-0.36], p=0.007), the fraction of immature reticulocytes (β = 0.97 [0.10-6.43], p=0.004), coefficient of variation of neutrophil lobularity (β = 0.13 [0.01-0.25], p=0.040) and mean lymphocyte cell size (β = 0.21 [0.08-0.34], p=0.001) were positively associated with the CAC score after adjustment for age, sex, body mass index (BMI), diabetes, glomerular filtration rate (GFR) and high-density lipoprotein (HDL). CONCLUSIONS: This study confirms the known association of RDW with the CAC score, and presents the fraction of immature reticulocytes, coefficient of variation of neutrophil lobularity, and mean lymphocyte cell size as new markers associated with a higher CAC score.
BACKGROUND AND AIMS: We aimed to improve the understanding of potential associations between commonly available hematological biomarkers and the coronary artery calcification (CAC) score, which may help unravel the pathophysiology of coronary calcifications and subclinical coronary artery disease. METHODS: A cross-sectional study was performed within the Utrecht Patient Oriented Database (UPOD). Patients with suspected or known coronary artery disease who underwent CT CAC scoring as well as standard hematology analysis that was part of routine clinical care (within 3 months of CT acquisition) were included. Complete hematology datasets were extracted from hematology analyzers. Linear regression adjusted for potential confounders was used to assess if hematological biomarkers were related to the CAC score. RESULTS: In total, 1504 patients were included, of whom 43% (n = 647) had a CAC score of 0. Mean age (±SD) was 53 ± 13 years, and 34% of patients were women. Red blood cell distribution width (RDW, β = 0.20 [0.05-0.36], p=0.007), the fraction of immature reticulocytes (β = 0.97 [0.10-6.43], p=0.004), coefficient of variation of neutrophil lobularity (β = 0.13 [0.01-0.25], p=0.040) and mean lymphocyte cell size (β = 0.21 [0.08-0.34], p=0.001) were positively associated with the CAC score after adjustment for age, sex, body mass index (BMI), diabetes, glomerular filtration rate (GFR) and high-density lipoprotein (HDL). CONCLUSIONS: This study confirms the known association of RDW with the CAC score, and presents the fraction of immature reticulocytes, coefficient of variation of neutrophil lobularity, and mean lymphocyte cell size as new markers associated with a higher CAC score.