Source: International Congress 2016 – Pulmonary hypertension and pulmonary embolism: from the bench to the bedside
Disease area: Pulmonary vascular diseases

Abstract

IntroductionDifferential blood count is routinely done at the time of diagnostic work-up and during follow-up of pulmonary arterial hypertension (PAH), however, the prognostic value of the specific cell counts is unknown.Aims and objectivesWe aimed to analyze white cell differential counts in PAH patients and their prognostic relevance.Patients and methodsIn this retrospective study we included n= 83 newly diagnosed (incident) PAH patients and n=71 patients where pulmonary hypertension was excluded by means of right heart catheterization. White blood cell differential counts were compared between groups using Mann Whitney U test. Area under the curve was calculated for each cell type as well as for neutrophil-to-lymphocyte ratio (NLR). Survival analysis was performed based on the best cut-off values. Data are presented as mean ± standard deviation.ResultsThe relative and absolute number of lymphocytes was decreased in PAH as compared to controls (22.3 ± 10 % vs. 25.4 ± 8.8 % , p<0.006, 1.5 ± 0.7 G/µl vs. 1.6 ± 0.6 G/µl, p<0.025). There was a slight but significant increase in the relative neutrophil count in PAH as compared to control (66.8 ± 11.5% vs. 64.4 ± 10.7%, p<0.037) but there were no differences in monocyte or eosinophil counts. NLR was slightly but significantly increased in PAH as compared to control (3.8 ± 2.5 vs. 3.3 ± 2.7 p<0.008). NLR ³2.62 identified PAH patients with a 69% sensitivity and 56% specificity and was associated with a poor overall 5 year survival in PAH patients (47% vs. 69%, p<0.038).ConclusionNeutrophil- to- lymphocyte ratio is a simple tool which may be of prognostic relevance in PAH patients.


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Vasile Foris (Graz, Austria), Vasile Foris, Gabor Kovacs, Philipp Douschan, Alexander Avian, Andrea Olschewski, Horst Olschewski. Neutrophil- to-lymphocyte ratio as a prognostic parameter in pulmonary arterial hypertension. Eur Respir J 2016; 48: Suppl. 60, 2479

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