Leukocyte count is associated with incidence of coronary events, but not with stroke: A prospective cohort study

  • Cairu Li
    Corresponding author at: Department of Clinical Science, Cardiovascular Epidemiology, Malm University Hospital, Malm s-20502, Sweden. Tel.: +46 46 391327; fax: +46 40 391300.
    Department of Clinical Sciences, Cardiovascular Epidemiology, Lund University, Malmö University Hospital, Malmö, Sweden
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  • Gunnar Engström
    Department of Clinical Sciences, Cardiovascular Epidemiology, Lund University, Malmö University Hospital, Malmö, Sweden

    AstraZeneca R&D, Lund, Sweden
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  • Bo Hedblad
    Department of Clinical Sciences, Cardiovascular Epidemiology, Lund University, Malmö University Hospital, Malmö, Sweden
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      Elevated leukocyte count is a classic marker of systemic inflammation. This study examined whether the leukocyte count is associated with incidence of coronary events (CE) and stroke during a long follow-up period.


      A total of 17,131 men and 2932 women, aged 27–61 years, without history of cardiovascular disease (CVD), were enrolled. Incidence of CE and stroke was studied in relation to leukocyte concentrations over a mean follow-up of 24 years.


      During the follow-up period, 2600 CE and 1333 stroke events occurred. After risk factor adjustments, leukocyte concentrations in the highest quartile (vs. lowest, >7.0 vs. <4.7 × 109 cells/L) were associated with CE in men (HR: 1.31, 95%CI: 1.16–1.48, trend p < 0.001), but not significantly in women (HR: 1.46, CI: 0.87–2.46, trend p = 0.13). The increased incidence remained significant after adjustments for plasma fibrinogen in a sub-group of 6018 men (HR: 1.31, CI: 1.08–1.60).
      The association between leukocytes and CE was most pronounced in younger men (aged 27–46) and men without hypertension. In younger men, high leukocytes were associated with early CE (within 10 years of follow-up) and late CE (>10 years of follow-up). In older men (46–61 years), leukocytes were not associated with CE after more than 10 years of follow-up.
      The leukocyte count was not associated with incidence of stroke.


      Elevated leukocyte count in men is associated with increased incidence of CE, but not with stroke. The increased risk persisted after more than 10 years of follow-up in younger, but not in older men.


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