Predictive Power of the Relative Lymphocyte Concentration in Patients With Advanced Heart Failure
Key result
A low relative lymphocyte concentration (<20.3%) was an independent predictor of mortality in advanced heart failure, with 4-year survival of 34% compared to 73% for normal levels (P=0.004).
Why the study?
Does a low relative lymphocyte concentration predict reduced survival and transplant-free survival in patients with advanced heart failure?
Population
211 patients with advanced symptomatic heart failure evaluated in a cardiac transplantation clinic. Key…
Comparison
Low relative lymphocyte concentration (%L < 20.3%) vs Normal relative lymphocyte concentration
Design
Cohort
Follow-up
up to 4 years
Authors
Discussion
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Member takes
Implication
May aid prognostication in advanced HF without changing practice; leaves open prospective validation in risk models.
Key Points
- To determine the prognostic significance of a low relative lymphocyte percentage for predicting overall and transplant-free survival in patients with advanced heart failure.
- Retrospectively reviewed 263 patients evaluated in a cardiac transplantation clinic between April 1988 and July 1995, analyzing N=211 after excluding 52 patients with recent trauma, infection, surgery, myocardial infarction, corticosteroid use, or cancer.
- Used univariate and multivariate Cox proportional hazards analyses to assess the relationship between baseline clinical characteristics and transplant-free survival.
- Patients with a low relative lymphocyte count (<20.3%) had 1-year and 4-year survival rates of 78% and 34%, compared to 90% and 73% in patients with normal levels.
- Multivariate analysis confirmed relative lymphocyte percentage (P<0.01) and New York Heart Association functional class (P<0.008) as independent predictors of both overall survival and survival free from cardiac transplantation.
Study Design
Type
Cohort (n=211)
Multicenter
No
Structured PICO
Does a low relative lymphocyte concentration predict reduced survival and transplant-free survival in patients with advanced heart failure?
P
Population
211 patients with advanced symptomatic heart failure evaluated in a cardiac transplantation clinic. Key exclusions: recent trauma, infection, surgery, myocardial infarction, corticosteroid use, or history of malignancy.
I
Intervention
Low relative lymphocyte concentration (%L < 20.3%)
C
Comparator
Normal relative lymphocyte concentration
O
Outcome
Survival (time to death) and survival free from cardiac transplantationhard clinical
Main Result
Absolute Event Rate: 34% vs 73%
p-value: p=.004
A low relative lymphocyte concentration (<20.3%) is a simple, independent prognostic marker for reduced survival and transplant-free survival in patients with advanced heart failure.
Cite This Study
Ommen et al. (1998) conducted a cohort in Advanced heart failure (n=211). Low percentage of lymphocytes (<20.3%) vs. Normal percentage of lymphocytes was evaluated on Time to death (p=.004). A low relative lymphocyte concentration (<20.3%) was an independent predictor of mortality in advanced heart failure, with 4-year survival of 34% compared to 73% for normal levels (P=0.004).