The relationship between eosinophil and cardiac syndrome X

Association Between Three Atopic Triad and Retinal Vein Occlusion Risk: A Nationwide Population-Based Study

PURPOSE

To evaluate the association between three allergic diseases (allergic dermatitis, allergic rhinitis, and asthma) and the development of retinal vein occlusion (RVO), a major retinal disease that causes visual impairment.

METHOD

This study used data obtained from the Korean National Health Insurance Claims database between 2009 and 2018. The association between the three atopic triads (allergic dermatitis, allergic rhinitis, and asthma) and the occurrence of sight-threatening RVO, as determined by diagnostic and treatment codes, were analyzed. Multivariate adjusted Cox regression analysis was used to determine the hazard ratios (HRs) and 95% confidence intervals for RVO development in the presence of allergic disease.

RESULTS

In this population-based study, 2,160,195 (54.6%) individuals were male, 1,794,968 (45.4%) were female, and 620,938 (15.7%) were diagnosed with allergic diseases. Patients with either asthma or allergic rhinitis had a greater risk of RVO (adjusted hazard ratio (aHR) = 1.101, 95% confidence interval [CI] = 1.029-1.178 for asthma; aHR = 1.181, 95% CI = 1.147-1.215 for allergic rhinitis) compared to those without asthma or allergic rhinitis; however, patients with atopic dermatitis did not show a significant association with RVO (aHR = 1.071, 95% CI = 0.889-1.290), after adjusting for other risk factors.

CONCLUSION

Our study revealed that allergic rhinitis, asthma, and coexisting multiple allergic conditions were associated with an increased risk of RVO. Thus, it may be advisable to suggest an ophthalmological examination for patients with allergies due to the increased possibility of the occurrence of retinal vascular disease.

Development of heart failure with preserved ejection fraction is independent of eosinophils in a preclinical model

The increasing burden of heart failure with preserved ejection fraction (HFpEF) has become a global health problem. HFpEF is characterized by systematic inflammation, cardiac metabolic remodeling, and fibrosis. Eosinophils act as an essential but generally overlooked subgroup of white blood cells, which participate in cardiac fibrosis, as reported in several recent studies. Herein, we explored the role of eosinophils in a "two-hit" preclinical HFpEF model. The peripheral eosinophil counts were comparable between the normal chow and HFpEF mice. Deficiency of eosinophils failed to alter the phenotype of HFpEF. Conclusively, the development of HFpEF is independent of eosinophils in terms of the functional, biochemical, and histological results.

Eosinophil percentage as a new prognostic marker in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Background

In addition to proinflammatory properties, eosinophils can stimulate platelet activation and enhance prothrombotic pathways. In this study, we aimed to investigate the association between the eosinophil percentage (EOS%) and major adverse cardiac events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI).

Methods

This study enrolled a total of 1,909 patients who were diagnosed with STEMI. Ventricular arrhythmia, reinfarction, the need for cardiopulmonary resuscitation, target vessel revascularization, congestive heart failure, and cardiovascular mortality during index hospitalization were defined as MACE.

Results

Three hundred and eighty patients (19.7%) reached the combined endpoint with MACE. The rates of inhospital mortality and MACE were significantly higher in low EOS% group as compared to high EOS% group (4% vs. 1.1%, p < 0.01 and 32.8% vs. 11.3%, p < 0.01, respectively). On multivariate logistic regression analyses, EOS% (OR = 0.44, p < 0.01) was found to be one of the independent predictors of MACE. The EOS% lower than 0.60 on admission predicted inhospital MACE with a sensitivity of 68% and a specificity of 72% (AUC: 0.684, p < 0.01).

Conclusions

Low EOS% on admission may be associated with high inhospital MACE in STEMI patients. EOS% may be used as a novel biomarker for risk stratification of these patients.

Ischemic priapism: Can eosinophil count and platelet functions be positive predictive factors in etiopathogenesis

INTRODUCTION

We evaluated the relation between ischemic priapism (IP) and blood count parameters in IP patients. We especially wanted to examine the contribution of eosinophil count (EC), platelet count (PC), and mean platelet volume (MPV) values, which are suspected predictive parameters for vascular endothelium damage and venoocclusive pathogenesis and etiopathogenesis, particularly in IP.

METHODS

A total of 40 IP patients fulfilled the study criteria. Forty healthy volunteers in a similar age group were included as the control group. Complete blood count values were compared between the two groups. Intergroup comparisons were performed using the Mann-Whitney U test, and the chi-square test was used to assess the relationship between categorical variables in the patient groups. The area under the curve was calculated by receiver operating characteristic (ROC) regression analyses. Epidemiological diagnosis percentages were calculated by finding cutoff values.

RESULTS

The IP group's high MPV, PC, and EC values compared to those of the control group were detected to be statistically significant (p<0.001, p=0,03, p=0.001, respectively). No statistically significant difference was observed between the two groups for other blood count parameters. Statistically significant values for IP were measured as MPV: positive predictive value: 84%; EC: positive predictive value: 71.4%; and PC: positive predictive value: 61.4%.

CONCLUSIONS

High MPV, PC, and EC values are significant positive predictive factors in IP etiopathogenesis. No proof was detected for other blood count parameters playing an active role in IP etiopathogenesis.

The relationship between eosinophilia and slow coronary flow

Aim

The pathophysiology of slow coronary flow (SCF) involves atherosclerosis, small vessel dysfunction, platelet function disorders, and inflammation. It has been known that eosinophils also play a significant role in inflammation, vasoconstriction, thrombosis, and endothelial dysfunction. We propose to evaluate the relationship between eosinophilia and SCF.

Methods

All patients who underwent coronary angiography between January 2011 and December 2013 were screened retrospectively. Of 6,832 patients, 102 patients with SCF (66 males, mean age 52.2±11.7 years) and 77 control subjects with normal coronary angiography (50 males, mean age 50.7±8.1 years) were detected. Baseline characteristics, hematological test results, and biochemical test results were obtained from the hospital database.

Results

Baseline characteristics of the study groups were comparable between groups. There was no significant difference between groups regarding leukocyte count, paletelet count, and mean platelet volume. However, patients with SCF had a higher eosinophil count than the controls (0.24±0.17×10³/μL vs 0.16±0.15×10³/μL, P=0.002). In addition, eosinophil count was found to be correlated with thrombolysis in myocardial infarction (TIMI) frame count in the SCF group (r=0.3, P<0.01). There was no significant correlation between eosinophil count and the number of coronary arteries showing slow flow.

Conclusion

Patients with SCF have higher blood eosinophil count, and this may play an important role in the pathogenesis of SCF. Elevated baseline eosinophil count may indicate the presence of SCF.