Distinct WBC Trajectories are Associated with the Risks of Incident CVD and All-Cause Mortality

• Published in: Journal of Atherosclerosis and Thrombosis Vol. 30; no. 10; pp. 1492 - 1506
• Main Authors: Yang, Wenhao, Wu, Shouling, Xu, Fangfang, Shu, Rong, Song, Haicheng, Chen, Shuohua, Shao, Zonghong, Cui, Liufu
• Format: Journal Article
• Language: English
• Published: Japan Japan Atherosclerosis Society 01-10-2023
• Subjects: All-cause mortality; Cardiovascular disease; Original; Trajectory; White blood cell counts; Cardiovascular disease; All-cause mortality; Trajectory; White blood cell counts
• ISSN: 1340-3478; 1880-3873
• DOI: 10.5551/jat.63887

Aims: To examine the trajectory of white blood cell (WBC) and their potential impacts on cardiovascular disease (CVD) and all-cause mortality (ACM) risks.Methods: This prospective cohort included 61,666 participants without CVD on or before June 1, 2012. Latent mixture modeling was used to identify WBC trajectories in 2006-2012 as predictors of CVD and ACM. Incident CVD and ACM in 2012-2019 were the outcomes. Cox proportional hazards models were fitted to analyze the risks of incident CVD and ACM.Results: According to WBC ranges and dynamics, five distinct WBC trajectories were identified: low-stable (n=18,432), moderate-stable (n=26,656), elevated-stable (n=3,153), moderate-increasing (n=11,622), and elevated-decreasing (n=1,803). During 6.65±0.83 years of follow-up, we documented 3773 incident CVD cases and 3304 deaths. Relative to the low-stable pattern, the moderate-increasing pattern was predictive of an elevated risk of CVD (HR=1.36, 95% CI: 1.24-1.50), especially acute myocardial infarction (AMI) (HR=1.91, 95% CI: 1.46-2.51), while the elevated-stable pattern was predictive of an elevated risk of ACM (HR=1.77, 95% CI: 1.52-2.06). Among participants with hs-CRP ＜2 mg/L or ≥2 mg/L, similar associations were observed between the moderate-increasing pattern with CVD (HR=1.41, 95% CI: 1.24-1.61) and ACM (HR=1.54, 95% CI: 1.18-2.01, HR=1.89, 95% CI: 1.57-2.29, respectively).Conclusions: We found that distinct WBC trajectories were differentially associated with CVD and ACM risks in Chinese adults.