Relative monocytosis predicts the presence and severity of coronary artery disease on CT coronary angiography in patients with stable angina symptoms

Abstract Background Monocytes, among other leucocytes, are crucially involved in the pathogenesis of atherosclerosis, but value peripheral blood leucocyte counts predicting presence or absence atherosclerotic coronary artery disease (CAD) is unknown. Purpose Investigating whether circulating monocytes, lymphocytes and neutrophils predict CAD on computed tomography angiography (CTCA) patients presenting with stable chest pain. Methods All investigated CTCA our centre year 2021 were screened (n=1564). Patients via Rapid Access Chest Pain clinic retrospectively identified, those a Full Blood Count from 6 months prior to included (n=330). Traditional cardiovascular risk factors ascertained letter. was defined as any epicardial stenosis >25% CTCA. further classified having either single multivessel (left main stem considered multivessel), non-obstructive obstructive (any >70% obstructive). Results had significantly higher mean monocyte count than without (0.61 vs. 0.55x109/L, p=0.004), while no differences observed between groups lymphocyte neutrophil count. Monocyte increased more severe CAD, being compared single-vessel (0.62 0.60x109/L; p for trend including =0.012), CAD=0.012). The association monocytes most marked history hypercholesterolaemia (monocyte CAD: 0.63 0.54x109/L, p=0.001), absent (0.57 vs 0.56x109/L, p=0.695). In subgroup (n=186), forward conditional logistic regression model alongside traditional (age, sex, smoking status, diabetes mellitus, hypertension, cholesterol level family history), showed that only increasing age (p<0.001), male sex (p<0.001) (p=0.01) independently predictive CAD. Conclusion Raised associated both severity anginal symptoms. hypercholesterolaemia, robust ability many factors. Further work needed establish relative monocytosis have would be predicted by tools. Funding Acknowledgement Type funding sources: None.