Prediction of calculated future cardiovascular disease by monocyte count in an asymptomatic population

INTRODUCTION: Although atherogenesis is clearly entwined with systemic inflammation, the risk-predictive relationship between preclinical and overt cardiovascular disease (CVD) and systemic white blood cell (WBC) subtypes remains unclear. Implication of an association would greatly facilitate cardiac risk prediction, assessment and monitoring. METHODS: 1383 asymptomatic individuals (795 men, 588 women) attending for executive health screening were examined clinically as well as with phlebotomy and exercise stress testing to determine their ten-year risk of developing overt cardiovascular disease (as estimated by both Framingham and SCORE calculations). The significance of their association with overall WBC and subtypes were determined using both univariate and multiple regression modeling. RESULTS: Of all WBC subtypes, monocyte count was found to have the strongest, independent relationship with overall CVD risk by backwards linear regression modeling (Framingham: β = 0.057; p = 0.03; SCORE: β = 0.128; p = <0.0005). Independent associations with BMI (β = 5.214; p = <0.0005), waist circumference (β = 21.866; p = <0.0005), systolic blood pressure (β = 10.738; p = 0.003), HDL cholesterol (β = −0.639; p = <0.0005) and triglyceride concentrations (β = 0.787; p = <0.0005) were also evident. Overall WBC along with neutrophils, lymphocytes and basophil subfractions were variably (but less strongly) associated with such dependents and outcome measures. CONCLUSIONS: In conclusion, monocyte count, a simple inexpensive test, may provide useful predictive cardiovascular risk information in asymptomatic individuals to inform and guide attempts at interrupting CVD development at a preclinical stage.