Peripheral Blood Cytopenia and Risk of Cardiovascular Disease and Mortality

Background Individual blood cell count abnormalities have been associated with cardiovascular disease and increased mortality. In this study, we defined a “cytopenia phenotype,” reflecting bone marrow hypoproliferation, to determine if peripheral blood cytopenia is associated with increased cardiova...

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Autores principales:	Radhika Gangaraju, Insu Koh, Marguerite R. Irvin, Leslie Lange, Damon E. Houghton, Diego Adrianzen Herrera, Monika Safford, Mary Cushman, Smita Bhatia, Neil A. Zakai
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	cardiovascular disease cytopenia mortality race stroke Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/a625d28be3e5415ca5a8a71c3fb96fed
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spelling	oai:doaj.org-article:a625d28be3e5415ca5a8a71c3fb96fed2021-11-23T11:36:35ZPeripheral Blood Cytopenia and Risk of Cardiovascular Disease and Mortality10.1161/JAHA.121.0208092047-9980https://doaj.org/article/a625d28be3e5415ca5a8a71c3fb96fed2021-09-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.121.020809https://doaj.org/toc/2047-9980Background Individual blood cell count abnormalities have been associated with cardiovascular disease and increased mortality. In this study, we defined a “cytopenia phenotype,” reflecting bone marrow hypoproliferation, to determine if peripheral blood cytopenia is associated with increased cardiovascular disease and mortality risk. Methods and Results Study participants were derived from a biracial observational cohort study, REGARDS (Reasons for Geographic and Racial Differences in Stroke), that enrolled 30 239 Black and White participants aged ≥45 years between 2003 and 2007. Median follow up was ≈9 years. The current study included 19 864 participants from REGARDS study (37.9% men, 40% Black participants) who have complete blood count available at study enrollment. We defined a cytopenia phenotype based on age‐, sex‐, and race‐adjusted lowest fifth percentile of blood counts. Multivariable Cox proportional hazards models estimated the hazard ratios (HR) and 95% CI of cytopenia for mortality and incident cardiovascular disease in adjusted models. Mean age of the study participants was 64 years (SD:9.7). The prevalence of cytopenia was 1.9% (n=378). Cytopenia was associated with increased risk of all‐cause mortality (HR, 1.73; 95% CI, 1.34–2.22) and cardiovascular disease mortality (HR, 1.56; 95% CI, 1.11–2.29). Cytopenia was associated with stroke risk in Black but not White participants (HR, 1.96 versus 0.86; P‐interaction for race=0.08) and was not associated with coronary heart disease risk. Conclusions We defined a cytopenia phenotype with clinical implications for mortality and stroke risk in a large biracial and geographically diverse population. Whether generated through somatic mutations or decreased organ function, cytopenia was associated with mortality risk and was a race‐specific risk factor for stroke.Radhika GangarajuInsu KohMarguerite R. IrvinLeslie LangeDamon E. HoughtonDiego Adrianzen HerreraMonika SaffordMary CushmanSmita BhatiaNeil A. ZakaiWileyarticlecardiovascular diseasecytopeniamortalityracestrokeDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cardiovascular disease cytopenia mortality race stroke Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	cardiovascular disease cytopenia mortality race stroke Diseases of the circulatory (Cardiovascular) system RC666-701 Radhika Gangaraju Insu Koh Marguerite R. Irvin Leslie Lange Damon E. Houghton Diego Adrianzen Herrera Monika Safford Mary Cushman Smita Bhatia Neil A. Zakai Peripheral Blood Cytopenia and Risk of Cardiovascular Disease and Mortality
description	Background Individual blood cell count abnormalities have been associated with cardiovascular disease and increased mortality. In this study, we defined a “cytopenia phenotype,” reflecting bone marrow hypoproliferation, to determine if peripheral blood cytopenia is associated with increased cardiovascular disease and mortality risk. Methods and Results Study participants were derived from a biracial observational cohort study, REGARDS (Reasons for Geographic and Racial Differences in Stroke), that enrolled 30 239 Black and White participants aged ≥45 years between 2003 and 2007. Median follow up was ≈9 years. The current study included 19 864 participants from REGARDS study (37.9% men, 40% Black participants) who have complete blood count available at study enrollment. We defined a cytopenia phenotype based on age‐, sex‐, and race‐adjusted lowest fifth percentile of blood counts. Multivariable Cox proportional hazards models estimated the hazard ratios (HR) and 95% CI of cytopenia for mortality and incident cardiovascular disease in adjusted models. Mean age of the study participants was 64 years (SD:9.7). The prevalence of cytopenia was 1.9% (n=378). Cytopenia was associated with increased risk of all‐cause mortality (HR, 1.73; 95% CI, 1.34–2.22) and cardiovascular disease mortality (HR, 1.56; 95% CI, 1.11–2.29). Cytopenia was associated with stroke risk in Black but not White participants (HR, 1.96 versus 0.86; P‐interaction for race=0.08) and was not associated with coronary heart disease risk. Conclusions We defined a cytopenia phenotype with clinical implications for mortality and stroke risk in a large biracial and geographically diverse population. Whether generated through somatic mutations or decreased organ function, cytopenia was associated with mortality risk and was a race‐specific risk factor for stroke.
format	article
author	Radhika Gangaraju Insu Koh Marguerite R. Irvin Leslie Lange Damon E. Houghton Diego Adrianzen Herrera Monika Safford Mary Cushman Smita Bhatia Neil A. Zakai
author_facet	Radhika Gangaraju Insu Koh Marguerite R. Irvin Leslie Lange Damon E. Houghton Diego Adrianzen Herrera Monika Safford Mary Cushman Smita Bhatia Neil A. Zakai
author_sort	Radhika Gangaraju
title	Peripheral Blood Cytopenia and Risk of Cardiovascular Disease and Mortality
title_short	Peripheral Blood Cytopenia and Risk of Cardiovascular Disease and Mortality
title_full	Peripheral Blood Cytopenia and Risk of Cardiovascular Disease and Mortality
title_fullStr	Peripheral Blood Cytopenia and Risk of Cardiovascular Disease and Mortality
title_full_unstemmed	Peripheral Blood Cytopenia and Risk of Cardiovascular Disease and Mortality
title_sort	peripheral blood cytopenia and risk of cardiovascular disease and mortality
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/a625d28be3e5415ca5a8a71c3fb96fed
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Peripheral Blood Cytopenia and Risk of Cardiovascular Disease and Mortality

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