Low lymphocyte count, as a marker of inflammation and immunosuppression, may be useful
for identifying frail patients. In this work, we aimed to evaluate the association
between low-relative lymphocyte count (Lymph%) and frailty status in patients >65
years old with acute coronary syndromes (ACS), and whether Lymph% is associated with
morbimortality beyond standard prognosticators and frailty. In this prospective observational
study, we included 488 hospital survivors of an episode of an ACS >65 years old. Total
and differential white blood cells and frailty status were assessed at discharge.
Frailty was evaluated using the Fried score at discharge and defined as Fried≥3. The
independent association between Lymph% and Fried≥3 was evaluated by multivariate logistic
regression analysis. The associations between Lymph% with long-term all-cause mortality
and recurrent admission were evaluated with Cox regression and shared frailty regression,
respectively. The mean age of the sample was 78 ± 7 years and 41% were females. The
median (interquartile range) of the Lymph% was 21% (15 to 27) and 41% showed Fried≥3.
In multivariate analysis, Lymph% was inversely related to the odds of frailty with
an exponential increase risk from values below 15% (p = 0.001). Likewise, Lymph% was
inverse and independently associated with a higher risk of long-term mortality (p = 0.011),
recurrent all-cause (p = 0.020), and cardiovascular readmissions (p = 0.024). In conclusion,
in patients >65 years with a recent ACS, low Lymph% evaluated at discharge is associated
with a higher risk of frailty. Low Lymph% was also associated with a higher risk of
long-term mortality and recurrent admissions beyond standard prognosticators and Fried
score.
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Article info
Publication history
Published online: January 06, 2020
Received in revised form:
January 2,
2020
Received:
November 1,
2019
Footnotes
Funding: This work was supported in part by grants from CIBER CV, Madrid, Spain [grant number 16/11/00420] and Instituto de Salud Carlos III-FEDER, Madrid, Spain [grant numbers PIE15/00013].
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