Does smoking status affect the association between baseline white blood cell count and in-hospital mortality of patients presented with acute coronary syndrome? The Greek study of acute coronary syndromes (GREECS).

OBJECTIVES: In this work, we sought to investigate whether smoking status modifies the effect of white blood cell count (WBC) on in-hospital mortality of patients presented with acute coronary syndrome (ACS). METHODS: A sample of 6 hospitals located in Greek urban and rural regions was selected. We recorded almost all consecutive patients due to ACS, from October 2003 to September 2004 (2172 patients). RESULTS: The mean (standard deviation) WBC count was 9.14 (3.16) cells/dL. The in-hospital mortality rate was higher in patients of upper tertile compared to those of lower tertile of WBC (p<0.05). The interaction between smoking status and WBC count revealed that smoking status modifies the effect of WBC count on mortality (p for interaction=0.004). Thus, stratified analysis showed that the WBC count is an independent predictor of in-hospital mortality only among former and current smokers. CONCLUSIONS: We demonstrated that the association between WBC count and mortality modified by smoking status and that WBC count is a predictor of mortality only among former and current smokers.

Epidemiology of acute coronary syndromes in a Mediterranean country; aims, design and baseline characteristics of the Greek study of acute coronary syndromes (GREECS).

BACKGROUND: The present study GREECS was conducted in order to evaluate the annual incidence of acute coronary syndromes (ACS) and to delineate the role of clinical, biochemical, lifestyle and behavioral characteristics on the severity of disease. In this work we present the design, methodology of the study and various baseline characteristics of people with ACS. METHODS/DESIGN: A sample of 6 hospitals located in Greek urban and rural regions was selected. In these hospitals we recorded almost all admissions due to ACS, from October 2003 to September 2004. Socio-demographic, clinical, dietary, psychological and other lifestyle characteristics were recorded. 2172 patients were included in the study (76% were men and 24% women). The crude annual incidence rate was 22.6 per 10,000 people and the highest frequency of events was observed in winter. The in-hospital mortality rate was 4.3%. The most common discharged diagnosis for men was Q-wave MI, while for women it was unstable angina. DISCUSSION: This study aims to demonstrate current information about the epidemiology of patients who suffer from ACS, in Greece.