White blood cell count and mortality in patients with ischemic and nonischemic left ventricular systolic dysfunction (an analysis of the studies of left ventricular dysfunction [SOLVD])

We conducted a retrospective analysis of the Studies OF Left Ventricular Dysfunction (SOLVD) trials to assess the predictive value of the baseline white blood cell (WBC) count on mortality, Mortality was higher in participants with a baseline WBC count >7,000 compared to those with a baseline WBC less than or equal to 7,000 (27% vs 21%, p <0.0001), After controlling for important covariates, each increase in WBC count of 1,000/mm(3) was significantly associated with an increased risk of: all-cause mortality (relative risk [RR] 1.05, p <0.001). Overall, compared with a baseline W8C count less than or equal to 7,000, a baseline WBC count >7,000 was significantly associated with an increased risk of all-cause mortality (RR 1.22, p = 0.001), In participants with ischemic left ventricular (LV) dysfunction, a WBC count >7,000 remained significantly associated with an increased risk of all-cause mortality (RR 1.26, p <0.001), whereas in participants with nonischemic LV dysfunction there was no relation between WBC count and mortality (RR 1.08, p = 0.5). Thus, baseline WBC is an independent predictor of mortality in patients with LV dysfunction, specifically in those with ischemic cardiomyopathy. (C) 1999 by Excerpta Medica, Inc.