Both High and low blood eosinophil counts predict risk of all-cause and cardiac deaths in patients with acute MI: Study
High and low blood eosinophil counts both predict the risk of all-cause and cardiac deaths in patients with acute myocardial infarction suggests a study published in the Journal of American Heart Association.
In patients with acute MI, low eosinophil counts at admission (<0.02×10⁹/L) and discharge (<0.03×10⁹/L) sharply increased 30-day all-cause and cardiac mortality risks. A synergistic effect was noted when both counts were low (OR, 13.93 for all-cause mortality | OR, 11.38 for cardiac mortality). Additionally, high eosinophil counts at discharge were independently tied to higher long-term mortality risk (HR, 1.84).
Preclinical studies demonstrate a cardioprotective role of eosinophils in acute myocardial infarction. Yet clinical studies show conflicting correlations between blood eosinophil counts and acute myocardial infarction risk and mortality.
This study evaluates blood eosinophil counts of patients with acute myocardial infarction at hospital admission (EOSbaseline) and discharge (EOSpost) on all-cause and cardiac mortalities. Of 2681 consecutive patients with a median follow-up of 2.55 years, 45 patients died within 30 days, 28 died within 30 to 150 days, and 92 died within 150 days or later postdischarge. Cardiac death occurred in 108 patients.
According to the receiver operating characteristic analyses, the best cutoffs of EOSbaseline and EOSpost were 0.02×109/L and 0.03×109/L, respectively, to predict 30-day all-cause death (area under the curve [AUC]baseline, 0.60; AUCpost, 0.67). The optimal cutoffs of EOSbaseline and EOSpost were 0.20×109/L and 0.14×109/L to predict long-term all-cause mortality (1-year AUCbaseline, 0.59; 1-year AUCpost, 0.61). Multivariate logistic analysis showed that low EOSbaseline (<0.02×109/L) or low EOSpost (<0.03×109/L) predicted the 30-day all-cause (odds ratio [OR]baseline, 2.56; P=0.005; ORpost, 8.14; P<0.001) and cardiac (ORbaseline, 2.16; P=0.025; ORpost, 7.89; P<0.001) mortalities. Patients with combined low EOSbaseline (<0.02×109/L) and low EOSpost (<0.03×109/L) displayed synergistic risk of 30-day all-cause (OR, 13.93; P<0.001) and cardiac (OR, 11.38; P<0.001) deaths. In contrast, adjusted Cox proportional hazard test indicated that high EOSpost (≥0.14×109/L) was an independent risk for long-term all-cause mortality (hazard ratio, 1.84; P=0.010).
High and low blood eosinophil counts both predict the risk of all-cause and cardiac deaths in patients with acute myocardial infarction depending on the time of data collection. Dynamic changes of blood eosinophil counts offer a more accurate prediction of post-myocardial infarction deaths than a single time point data analysis.
Reference:
Lin K, Luo M, Gu X, Xu JY, Tian J, Libby P, Shi GP, Guo J. Changes in Blood Eosinophil Counts Predict the Death of Patients With Myocardial Infarction After Hospital Discharge. J Am Heart Assoc. 2024 Dec 20:e035383. doi: 10.1161/JAHA.124.035383. Epub ahead of print. PMID: 39704243.
