title: Successful reperfusion for acute ST elevation myocardial infarction is associated with a decrease in WBC count.
abstract: BACKGROUND
  Elevated white blood cell (WBC) count on admission in patients with ST segment elevation myocardial infarction (STEMI) has been associated with an adverse prognosis. Whether successful reperfusion by primary percutaneous coronary intervention (PCI) is associated with a decrease in WBC count is unknown.
  
  
  METHODS
  In this subanalysis of the On-TIME trial, WBC count was measured on admission and 6 h and 24 h after primary PCI for STEMI (n = 364). Angiographic measurements of reperfusion, including TIMI-flow and myocardial blush grade, were compared with changes in WBC count.
  
  
  RESULTS
  Restoration of TIMI 3 flow by primary PCI was associated with a significant decrease in median WBC count (11.5 (9.7-14.2), 10.7 (9.0-12.5), 9.9 (8.5-11.5) at baseline, 6 h and 24 h), whereas after unsuccessful PCI (TIMI < 3 flow) WBC count remained elevated (12.5 (9.5-14.6), 12.1 (9.9-14.4), and 11.4 (9.2-15.2)). Improved myocardial blush was also related to a decrease in WBC count. After multivariate analysis, improved myocardial perfusion (TIMI 3 flow and myocardial blush grade 3) was an independent predictor of a decrease of WBC count after PCI.
  
  
  CONCLUSIONS
  Impaired myocardial reperfusion after primary PCI for STEMI is associated with persistent WBC elevation.
authors.affiliation: Department of Cardiology, Isala Klinieken, Zwolle, the Netherlands.
authors.forename: Jaap Jan J
authors.initials: JJ
authors.lastname: Smit
authors.forename: Jan Paul
authors.initials: JP
authors.lastname: Ottervanger
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: Slingerland
authors.forename: Harry
authors.initials: H
authors.lastname: Suryapranata
authors.forename: Jan C A
authors.initials: JC
authors.lastname: Hoorntje
authors.forename: Jan Henk E
authors.initials: JH
authors.lastname: Dambrink
authors.forename: A T Marcel
authors.initials: AT
authors.lastname: Gosselink
authors.forename: Menko-Jan
authors.initials: MJ
authors.lastname: de Boer
authors.forename: Arnoud W J
authors.initials: AW
authors.lastname: van 't Hof
mesh_terms: D000208:Acute Disease; D000368:Aged; D015415:Biomarkers; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000009:adverse effects; D015428:Myocardial Reperfusion Injury / Q000175:diagnosis / Q000276:immunology; D011237:Predictive Value of Tests; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers