The white blood cell count is an independent predictor of no-reflow and mortality following acute myocardial infarction in the coronary interventional era.
BACKGROUND
In the era before the use of coronary reperfusion therapy, an elevated white blood cell (WBC) count was associated with a higher risk of adverse events following acute myocardial infarction (AMI). However, the relationship between WBC count and prognosis after AMI has not been investigated since coronary intervention was introduced.


OBJECTIVE
To evaluate whether a high WBC count within 48 hours of the onset of AMI predicts future adverse events in patients undergoing percutaneous coronary intervention (PCI).


METHODS
We evaluated 1,016 patients who underwent PCI in the acute phase of MI using the Japanese Acute Coronary Syndrome Study (JACSS) database. RESULTS. WBC count was significantly associated with smoking, sudden onset AMI, and the no-reflow phenomenon during PCI, as were age, peak creatine kinase level, and Killip class. An elevated WBC count was significantly associated with higher risk of in-hospital mortality. Patients in the highest quartile of WBC count were about three times more likely to have a poor prognosis after AMI compared to those in the lowest quartile.


CONCLUSIONS
The WBC count is of great significance for stratifying patient risk and can be used as a universal marker for predicting future adverse events following any treatment for AMI.
Kojima
Sunao
S
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan. kojimas@kumamoto-u.ac.jp
Sakamoto
Tomohiro
T
Ishihara
Masaharu
M
Kimura
Kazuo
K
Miyazaki
Shunichi
S
Tei
Chuwa
C
Hiraoka
Hisatoyo
H
Sonoda
Masahiro
M
Tsuchihashi
Kazufumi
K
Yamagishi
Masakazu
M
Inoue
Takeshi
T
Asada
Yujiro
Y
Ikeda
Yoshihiko
Y
Shirai
Mutsunori
M
Ogawa
Hisao
H
D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015992:Body Mass Index; D003326:Coronary Circulation / Q000502:physiology*; D003402:Creatine Kinase / Q000097:blood; D019992:Databases as Topic; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications; D007564:Japan / Q000453:epidemiology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D012907:Smoking / Q000097:blood
D003402:Creatine Kinase