Association Between White Blood Cell Counts at Diagnosis and Clinical Outcomes in Venous Thromboembolism ― From the COMMAND VTE Registry-2 ―
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: White blood cell (WBC) counts were reported to be a risk factor for acute adverse events in patients with venous thromboembolism (VTE). However, there are limited data on VTE patients without active cancer. METHODS AND RESULTS: The COMMAND VTE Registry-2 was a multicenter study enrolling 5,197 consecutive patients with acute symptomatic VTE. We divided 3,668 patients without active cancer into 4 groups based on WBC count quartiles (Q1-Q4) at diagnosis: Q1, ≤5,899 cells/μL; Q2, 5,900-7,599 cells/μL, Q3, 7,600-9,829 cells/μL; and Q4, ≥9,830 cells/μL. Patients in Q4 more often presented with pulmonary embolism (PE) than patients in Q1, Q2, and Q3 (68% vs. 37%, 53%, and 61%, respectively; P<0.001). The proportion of massive PEs among all PEs was higher in Q4 than in Q1, Q2, and Q3 (21% vs. 3.4%, 5.8%, and 11%, respectively; P<0.001). Compared with Q1, Q2, and Q3, patients in Q4 had a higher cumulative 5-year incidence of all-cause death (17.0%, 15.2%, 16.1%, and 22.8%, respectively; P<0.001) and major bleeding (10.9%, 11.0%, 10.3%, and 14.4%, respectively; P=0.002). The higher mortality risk of Q4 relative to Q2 was consistent regardless of the presentations of VTEs. CONCLUSIONS: An elevated WBC count on VTE diagnosis was associated with a higher risk of mortality and major bleeding regardless of VTE presentation, suggesting the potential usefulness of WBC counts for further risk stratification.
Source: Circulation Journal
Authors: Shinya Ikeda, Yugo Yamashita, Takeshi Morimoto, Ryuki Chatani, Kazuhisa Kaneda, Yuji Nishimoto, Nobutaka Ikeda, Yohei Kobayashi, Satoshi Ikeda, Kitae Kim, Moriaki Inoko, Toru Takase, Shuhei Tsuji, Maki Oi, Takuma Takada, Kazunori Otsui, Jiro Sakamoto, Yoshito Ogihara, Takeshi Inoue, Shunsuke Usami, Po-Min Chen, Kiyonori Togi, Norimichi Koitabashi, Seiichi Hiramori, Kosuke Doi, Hiroshi Mabuchi, Yoshiaki Tsuyuki, Koichiro Murata, Kensuke Takabayashi, Hisato Nakai, Daisuke Sueta, Wataru Shioyama, Tomohiro Dohke, Ryusuke Nishikawa, Koh Ono, Takeshi Kimura
Institutions: Shiga University of Medical Science, Kyoto University, Nagasaki University, Hyogo Medical University, Kurashiki Central Hospital, Hyogo Prefectural Amagasaki General Medical Center, Toho University Ohashi Medical Center, Osaka Red Cross Hospital, Kobe City Medical Center General Hospital, Kitano Hospital, Kindai University Hospital, Japanese Red Cross Society Wakayama Medical Center, Otsu Red Cross Hospital, Tokyo Women's Medical University, Kobe University Hospital, Tenri Hospital, Mie University, Kansai Electric Power (Japan), Kansai Electric Power Hospital, Saiseikai Noe Hospital, Kindai University Nara Hospital, Kindai University, Gunma University, Kokura Memorial Hospital, Kyoto Medical Center, Koto Hospital, Koto Memorial Hospital, Shimada Municipal Hospital, Shizuoka City Hospital, Hirakata Kohsai Hospital, Sugita Genpaku Memorial Obama Municipal Hospital, Kumamoto University, Kohka Public Hospital
Language: English
Subfield: Internal Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Funder: Japan Lifeline
OpenAlex ID: W4403589617