[Leucocytosis associated with higher incidence of adverse cardiovascular events in myocardial infarcts].
In acute phase leukocytes has been related with higher incidence of major adverse cardiovascular events, (MACE) this evidence in AMI ST elevation after mechanical reperfusion is poor. We study prospectively this group to relationship among mechanical reperfusion, leukocytes and MACE. Two groups were considered < 10,000/microL or > 10,000/microL; 271 patients had full inclusion criteria in a 5 year period; 93 had < 1 0,000/microL leukocytes. (8,300 +/- 1,254/microL) and 178 > 10,000/microL. (13,810 +/- 3,192/microL, p 0.0001). We did not observe any difference between both groups regarding demographic characteristics. At beginning leukocytosis group had higher flow TIMI 0 - 1 incidence (89% vs 75%, p 0.004) and in-hospital major cardiovascular adverse events (32% vs 14%, p 0.001) and in follow-up (5% vs 2%, p 0.04). Logistic regression model include > 60 years-old, diabetes, extensive anterior or inferior infarction, TIMI flow 0, 1, or 2, cardiogenic shock, leukocytosis and neuthrophilia, had close relationship with mortality (p = 0.0007, RM 1.40, IC 95% 0.410 - 4.841). Multiple regression that include leukocytosis and neuthrophlia had stronger correlation with major cardiovascular adverse events (mortality, r = 0.34 and cardiogenic shock, r = 0.27) and abnormal TIMI flow (r = 0.20).


CONCLUSIONS
Our results confirm close relationship among leukocitosis, thrombosis and major cardiovascular adverse events and extend this knowledge to acute phase and follow- up in acute myocardial infarction ST elevation under percutaneous coronary intervention. These results could be considered as evidence that connecting between endotelial dysfunction (inflammation-atherothrombosis) and cardiovascular disease.
Comparan-Núñez
Alfredo
A
Hospital de Enfermedades Cardiovasculares y del Tórax, Centro Médico del Norte, IMSS, Monterrey, México.
Palacios
Juan M
JM
Jerjes-Sánchez
Carlos D
CD
D015906:Angioplasty, Balloon, Coronary; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007964:Leukocytosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000601:surgery*; D011446:Prospective Studies; D012044:Regression Analysis