Commonly available hematological biomarkers are associated with the extent of coronary calcifications

Annemarie M. den Harder*, Pim A. de Jong, Mark C.H. de Groot, Jelmer M. Wolterink, Ricardo P.J. Budde, Ivana Iŝgum, Wouter W. van Solinge, Maarten J. ten Berg, Esther Lutgens, Wouter B. Veldhuis, Saskia Haitjema, Imo E. Hoefer, Tim Leiner

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Scopus)


Background and aims: We aimed to improve the understanding of potential associations between commonly available hematological biomarkers and the coronary artery calcification (CAC) score, which may help unravel the pathophysiology of coronary calcifications and subclinical coronary artery disease.

Methods: A cross-sectional study was performed within the Utrecht Patient Oriented Database (UPOD). Patients with suspected or known coronary artery disease who underwent CT CAC scoring as well as standard hematology analysis that was part of routine clinical care (within 3 months of CT acquisition) were included. Complete hematology datasets were extracted from hematology analyzers. Linear regression adjusted for potential confounders was used to assess if hematological biomarkers were related to the CAC score.

Results: In total, 1504 patients were included, of whom 43% (n = 647) had a CAC score of 0. Mean age (±SD) was 53 ± 13 years, and 34% of patients were women. Red blood cell distribution width (RDW, β = 0.20 [0.05–0.36], p=0.007), the fraction of immature reticulocytes (β = 0.97 [0.10–6.43], p=0.004), coefficient of variation of neutrophil lobularity (β = 0.13 [0.01–0.25], p=0.040) and mean lymphocyte cell size (β = 0.21 [0.08–0.34], p=0.001) were positively associated with the CAC score after adjustment for age, sex, body mass index (BMI), diabetes, glomerular filtration rate (GFR) and high-density lipoprotein (HDL).

Conclusions: This study confirms the known association of RDW with the CAC score, and presents the fraction of immature reticulocytes, coefficient of variation of neutrophil lobularity, and mean lymphocyte cell size as new markers associated with a higher CAC score.

Original languageEnglish
Pages (from-to)166-173
Number of pages8
Publication statusPublished - Aug 2018
Externally publishedYes


  • Association
  • Biomarker
  • Cardiac CT
  • Coronary artery calcification
  • Hematology
  • Relationship


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