Characteristics of peripheral blood cells are independently related to major adverse cardiovascular events after carotid endarterectomy

L. Malin Overmars; Joost M. Mekke; Wouter W. van Solinge; Saskia C.A. De Jager; Cornelia A.R. Hulsbergen-Veelken; Imo E. Hoefer; Dominique P.V. de Kleijn; Gert J. de Borst; Sander W. van der Laan; Saskia Haitjema

doi:10.1016/j.athplu.2023.05.003

Characteristics of peripheral blood cells are independently related to major adverse cardiovascular events after carotid endarterectomy

L. Malin Overmars^*, Joost M. Mekke, Wouter W. van Solinge, Saskia C.A. De Jager, Cornelia A.R. Hulsbergen-Veelken, Imo E. Hoefer, Dominique P.V. de Kleijn, Gert J. de Borst, Sander W. van der Laan, Saskia Haitjema

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

6 Downloads (Pure)

Abstract

BACKGROUND AND AIMS: Patients who underwent carotid endarterectomy (CEA) still have a residual risk of 13% of developing a major adverse cardiovascular event (MACE) within 3 years. Inflammatory processes leading up to MACE are not fully understood. Therefore, we examined blood cell characteristics (BCCs), possibly reflecting inflammatory processes, in relation to MACE to identify BCCs that may contribute to an increased risk.

METHODS: We analyzed 75 pretreatment BCCs from the Sapphire analyzer, and clinical data from the Athero-Express biobank in relation to MACE after CEA using Random Survival Forests, and a Generalized Additive Survival Model. To understand biological mechanisms, we related the identified variables to intraplaque hemorrhage (IPH).

RESULTS: Of 783 patients, 97 (12%) developed MACE within 3 years after CEA. Red blood cell distribution width (RDW) (HR 1.23 [1.02, 1.68], p = 0.022), CV of lymphocyte size (LACV) (HR 0.78 [0.63, 0.99], p = 0.043), neutrophil complexity of the intracellular structure (NIMN) (HR 0.80 [0.64, 0.98], p = 0.033), mean neutrophil size (NAMN) (HR 0.67 [0.55, 0.83], p < 0.001), mean corpuscular volume (MCV) (HR 1.35 [1.09, 1.66], p = 0.005), eGFR (HR 0.65 [0.52, 0.80], p < 0.001); and HDL-cholesterol (HR 0.62 [0.45, 0.85], p = 0.003) were related to MACE. NAMN was related to IPH (OR 0.83 [0.71-0.98], p = 0.02).

CONCLUSIONS: This is the first study to present a higher RDW and MCV and lower LACV, NIMN and NAMN as biomarkers reflecting inflammatory processes that may contribute to an increased risk of MACE after CEA.

Original language	English
Pages (from-to)	32-40
Number of pages	9
Journal	Atherosclerosis Plus
Volume	52
DOIs	https://doi.org/10.1016/j.athplu.2023.05.003
Publication status	Published - Jun 2023

Keywords

Blood cell characteristics
Carotid endarterectomy
Hematology
Inflammation
Intraplaque hemorrhage
Machine learning
Major adverse cardiovascular events
Routine care data

Access to Document

10.1016/j.athplu.2023.05.003Licence: CC BY-NC-ND

1-s2.0-S2667089523000081-mainFinal published version, 1.09 MBLicence: CC BY-NC-ND

Cite this

Overmars, L. M., Mekke, J. M., van Solinge, W. W., De Jager, S. C. A., Hulsbergen-Veelken, C. A. R., Hoefer, I. E., de Kleijn, D. P. V., de Borst, G. J., van der Laan, S. W., & Haitjema, S. (2023). Characteristics of peripheral blood cells are independently related to major adverse cardiovascular events after carotid endarterectomy. Atherosclerosis Plus, 52, 32-40. https://doi.org/10.1016/j.athplu.2023.05.003

@article{ce58301079ad4d7e846dee22c39708c0,

title = "Characteristics of peripheral blood cells are independently related to major adverse cardiovascular events after carotid endarterectomy",

abstract = "BACKGROUND AND AIMS: Patients who underwent carotid endarterectomy (CEA) still have a residual risk of 13% of developing a major adverse cardiovascular event (MACE) within 3 years. Inflammatory processes leading up to MACE are not fully understood. Therefore, we examined blood cell characteristics (BCCs), possibly reflecting inflammatory processes, in relation to MACE to identify BCCs that may contribute to an increased risk.METHODS: We analyzed 75 pretreatment BCCs from the Sapphire analyzer, and clinical data from the Athero-Express biobank in relation to MACE after CEA using Random Survival Forests, and a Generalized Additive Survival Model. To understand biological mechanisms, we related the identified variables to intraplaque hemorrhage (IPH).RESULTS: Of 783 patients, 97 (12%) developed MACE within 3 years after CEA. Red blood cell distribution width (RDW) (HR 1.23 [1.02, 1.68], p = 0.022), CV of lymphocyte size (LACV) (HR 0.78 [0.63, 0.99], p = 0.043), neutrophil complexity of the intracellular structure (NIMN) (HR 0.80 [0.64, 0.98], p = 0.033), mean neutrophil size (NAMN) (HR 0.67 [0.55, 0.83], p < 0.001), mean corpuscular volume (MCV) (HR 1.35 [1.09, 1.66], p = 0.005), eGFR (HR 0.65 [0.52, 0.80], p < 0.001); and HDL-cholesterol (HR 0.62 [0.45, 0.85], p = 0.003) were related to MACE. NAMN was related to IPH (OR 0.83 [0.71-0.98], p = 0.02).CONCLUSIONS: This is the first study to present a higher RDW and MCV and lower LACV, NIMN and NAMN as biomarkers reflecting inflammatory processes that may contribute to an increased risk of MACE after CEA.",

keywords = "Blood cell characteristics, Carotid endarterectomy, Hematology, Inflammation, Intraplaque hemorrhage, Machine learning, Major adverse cardiovascular events, Routine care data",

author = "Overmars, {L. Malin} and Mekke, {Joost M.} and {van Solinge}, {Wouter W.} and {De Jager}, {Saskia C.A.} and Hulsbergen-Veelken, {Cornelia A.R.} and Hoefer, {Imo E.} and {de Kleijn}, {Dominique P.V.} and {de Borst}, {Gert J.} and {van der Laan}, {Sander W.} and Saskia Haitjema",

note = "Funding Information: This work was supported by the Netherlands Cardiovascular Research Initiative : an initiative with support of the Dutch Heart Foundation ( CVON-GENIUS-2 to GP and SWvdL & CVON2017-5 Persuasive to DdK). We are thankful for the support of the ERA-CVD program {\textquoteleft}druggable-MI-targets {\textquoteright} (grant number: 01KL1802 , SWvdL ), the EU H2020 TO_AITION (grant number: 848146 , SWvdL ), EU H2020 Taxinomisis (grant number 755320 GP , GJB , DdK ), and the Leducq Fondation {\textquoteleft}PlaqOmics{\textquoteright} ( GP , SWvdL ). JMM was funded on a Dutch Heart Foundation Dekker grant (grant 2017T067 ). Publisher Copyright: {\textcopyright} 2023 The Authors",

year = "2023",

month = jun,

doi = "10.1016/j.athplu.2023.05.003",

language = "English",

volume = "52",

pages = "32--40",

}

Overmars, LM, Mekke, JM, van Solinge, WW , De Jager, SCA, Hulsbergen-Veelken, CAR, Hoefer, IE, de Kleijn, DPV , de Borst, GJ , van der Laan, SW & Haitjema, S 2023, 'Characteristics of peripheral blood cells are independently related to major adverse cardiovascular events after carotid endarterectomy', Atherosclerosis Plus, vol. 52, pp. 32-40. https://doi.org/10.1016/j.athplu.2023.05.003

TY - JOUR

T1 - Characteristics of peripheral blood cells are independently related to major adverse cardiovascular events after carotid endarterectomy

AU - Overmars, L. Malin

AU - Mekke, Joost M.

AU - van Solinge, Wouter W.

AU - De Jager, Saskia C.A.

AU - Hulsbergen-Veelken, Cornelia A.R.

AU - Hoefer, Imo E.

AU - de Kleijn, Dominique P.V.

AU - de Borst, Gert J.

AU - van der Laan, Sander W.

AU - Haitjema, Saskia

N1 - Funding Information: This work was supported by the Netherlands Cardiovascular Research Initiative : an initiative with support of the Dutch Heart Foundation ( CVON-GENIUS-2 to GP and SWvdL & CVON2017-5 Persuasive to DdK). We are thankful for the support of the ERA-CVD program ‘druggable-MI-targets ’ (grant number: 01KL1802 , SWvdL ), the EU H2020 TO_AITION (grant number: 848146 , SWvdL ), EU H2020 Taxinomisis (grant number 755320 GP , GJB , DdK ), and the Leducq Fondation ‘PlaqOmics’ ( GP , SWvdL ). JMM was funded on a Dutch Heart Foundation Dekker grant (grant 2017T067 ). Publisher Copyright: © 2023 The Authors

PY - 2023/6

Y1 - 2023/6

N2 - BACKGROUND AND AIMS: Patients who underwent carotid endarterectomy (CEA) still have a residual risk of 13% of developing a major adverse cardiovascular event (MACE) within 3 years. Inflammatory processes leading up to MACE are not fully understood. Therefore, we examined blood cell characteristics (BCCs), possibly reflecting inflammatory processes, in relation to MACE to identify BCCs that may contribute to an increased risk.METHODS: We analyzed 75 pretreatment BCCs from the Sapphire analyzer, and clinical data from the Athero-Express biobank in relation to MACE after CEA using Random Survival Forests, and a Generalized Additive Survival Model. To understand biological mechanisms, we related the identified variables to intraplaque hemorrhage (IPH).RESULTS: Of 783 patients, 97 (12%) developed MACE within 3 years after CEA. Red blood cell distribution width (RDW) (HR 1.23 [1.02, 1.68], p = 0.022), CV of lymphocyte size (LACV) (HR 0.78 [0.63, 0.99], p = 0.043), neutrophil complexity of the intracellular structure (NIMN) (HR 0.80 [0.64, 0.98], p = 0.033), mean neutrophil size (NAMN) (HR 0.67 [0.55, 0.83], p < 0.001), mean corpuscular volume (MCV) (HR 1.35 [1.09, 1.66], p = 0.005), eGFR (HR 0.65 [0.52, 0.80], p < 0.001); and HDL-cholesterol (HR 0.62 [0.45, 0.85], p = 0.003) were related to MACE. NAMN was related to IPH (OR 0.83 [0.71-0.98], p = 0.02).CONCLUSIONS: This is the first study to present a higher RDW and MCV and lower LACV, NIMN and NAMN as biomarkers reflecting inflammatory processes that may contribute to an increased risk of MACE after CEA.

AB - BACKGROUND AND AIMS: Patients who underwent carotid endarterectomy (CEA) still have a residual risk of 13% of developing a major adverse cardiovascular event (MACE) within 3 years. Inflammatory processes leading up to MACE are not fully understood. Therefore, we examined blood cell characteristics (BCCs), possibly reflecting inflammatory processes, in relation to MACE to identify BCCs that may contribute to an increased risk.METHODS: We analyzed 75 pretreatment BCCs from the Sapphire analyzer, and clinical data from the Athero-Express biobank in relation to MACE after CEA using Random Survival Forests, and a Generalized Additive Survival Model. To understand biological mechanisms, we related the identified variables to intraplaque hemorrhage (IPH).RESULTS: Of 783 patients, 97 (12%) developed MACE within 3 years after CEA. Red blood cell distribution width (RDW) (HR 1.23 [1.02, 1.68], p = 0.022), CV of lymphocyte size (LACV) (HR 0.78 [0.63, 0.99], p = 0.043), neutrophil complexity of the intracellular structure (NIMN) (HR 0.80 [0.64, 0.98], p = 0.033), mean neutrophil size (NAMN) (HR 0.67 [0.55, 0.83], p < 0.001), mean corpuscular volume (MCV) (HR 1.35 [1.09, 1.66], p = 0.005), eGFR (HR 0.65 [0.52, 0.80], p < 0.001); and HDL-cholesterol (HR 0.62 [0.45, 0.85], p = 0.003) were related to MACE. NAMN was related to IPH (OR 0.83 [0.71-0.98], p = 0.02).CONCLUSIONS: This is the first study to present a higher RDW and MCV and lower LACV, NIMN and NAMN as biomarkers reflecting inflammatory processes that may contribute to an increased risk of MACE after CEA.

KW - Blood cell characteristics

KW - Carotid endarterectomy

KW - Hematology

KW - Inflammation

KW - Intraplaque hemorrhage

KW - Machine learning

KW - Major adverse cardiovascular events

KW - Routine care data

UR - http://www.scopus.com/inward/record.url?scp=85161628318&partnerID=8YFLogxK

U2 - 10.1016/j.athplu.2023.05.003

DO - 10.1016/j.athplu.2023.05.003

M3 - Article

C2 - 37389152

AN - SCOPUS:85161628318

SN - 2667-0909

VL - 52

SP - 32

EP - 40

JO - Atherosclerosis Plus

JF - Atherosclerosis Plus

ER -

Characteristics of peripheral blood cells are independently related to major adverse cardiovascular events after carotid endarterectomy

Abstract

Keywords

Access to Document

Other files and links

Fingerprint