The association of elevated white blood cell count and C-reactive protein with endothelial dysfunction in cardiac syndrome X

Y. Atmaca; C. Ozdol; S. Turhan; K. Vurgun; V. Duzen; C. Erdol

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Document Details :

Title: The association of elevated white blood cell count and C-reactive protein with endothelial dysfunction in cardiac syndrome X
Author(s): Y. Atmaca , C. Ozdol , S. Turhan , K. Vurgun , V. Duzen , C. Erdol
Journal: Acta Cardiologica
Volume: 63 Issue: 6 Date: 2008
Pages: 723-728
DOI: 10.2143/AC.63.6.2033389

Abstract :
Background — The aim of the study is to evaluate the association of inflammatory markers with endothelial function in syndrome X.
Methods — The study population consisted of 59 prospectively enrolled patients (28 women and 31 men; mean age, 50.29 ± 6.48 years) and 51 healty control subjects (18 women and 33 men; mean age, 51.04 ± 7.25 years). High-sensitive CRP (hs-CRP), white blood cell (WBC) count and its subtypes [neutrophil (N), lymphocyte (L) and monocyte (M)] were measured in each subject. Endothelial function was assessed with the brachial artery flow-mediated dilatation (FMD) technique.
Results — WBC counts and hs-CRP levels were significantly higher in patients who had syndrome X than in control subjects (7.53 ± 1.52 x 10⁹ cells/L versus 6.21 ± 1.17 x 10⁹ cells/L, P = 0.0001, and 3.11 ± 0.63 mg/L versus 2.68 ± 0.76 mg/L, P = 0.002, respectively). Neutrophil count and N/L ratio was significantly increased in syndrome X when compared with the control subjects (5.14 ± 1.10 x 10⁹ cells/L versus 4.11 ± 0.76 x 10⁹ cells/L, P = 0.0001 and 2.75 ± 1.06 versus 2.37 ± 0.65, P = 0.02, repectively). Other subtype counts were similar between the groups. FMD was impaired significantly in patients who had syndrome X in comparison with the control subjects (5.71 ± 4.08% versus 16.02 ± 4.13%, P = 0.0001). There was a significant correlation between hs-CRP levels and FMD measurements (r = –0.44; P = 0.0001). Furthermore, the correlation between WBC count and FMD measurements
were also significant (r = –0.48; P = 0.0001).
Conclusions — The present study showed that hs-CRP and WBC count were higher in patients with syndrome X than in control subjects. Furthermore, endothelial function was impaired significantly in patients with syndrome X. The increased levels of hs-CRP and WBC count may suggest that these markers may be used in clinical practice for the assessment of the inflammatory status of the endothelium in syndrome X.