Relationship of admission haematological indices with infarct-related artery patency in patients with acute ST-segment elevation myocardial infarction treated with primary angioplasty.
OBJECTIVE
Mean platelet volume (MPV), a marker for platelet reactivity, and white blood cell count (WBC-C), a marker for inflammation, have been shown to be predictive of unfavourable outcomes among survivors of ST elevation myocardial infarction (STEMI). The relationship of admission MPV and WBC-C with infarct-related artery (IRA) patency is not clear. We aimed to evaluate the value of admission MPV and WBC-C for the prediction of IRA patency, in patients with acute STEMI treated with primary percutaneous coronary intervention.


METHODS
Blood samples were obtained on admission in 351 STEMI patients. The patients who had thrombolysis in myocardial infarction (TIMI) 3 flow in initial angiography constituted the IRA patent group and others having less than TIMI 3 flow constituted the IRA occluded group.


RESULTS
In 16% of the patients, IRAs were found to be patent on initial angiography. Patients in the IRA occluded group had higher admission MPVs (9.3+/-1.2 vs. 8.6+/-1.3 fl, P<0.001) and higher WBC-C (13.3+/-4.8 vs. 11.0+/-2.9, P=0.002) compared with patients in the patent IRA group. In regression analysis, WBC-Cs [beta, 0.131; odds ratio (OR), 1.140; 95% confidence interval (CI), 1.043-1.245, P=0.004)] and MPV (beta, 0.519; OR, 1.680; 95% CI, 1.206-2.339, P=0.002) were found to be independent predictors of occluded IRA. The best cutoff value of MPV for predicting an occluded IRA was determined to be 8.55 fl with a sensitivity of 74% and a specificity of 60%.


CONCLUSIONS
MPV and WBC-C at admission might be valuable in the prediction of IRA patency and in planning the need for adjunctive therapy to improve outcomes in patients with STEMI undergoing percutaneous coronary intervention.
Maden
Orhan
O
Cardiology Department, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey. dorhanmaden@yahoo.co.uk
Kacmaz
Fehmi
F
Selcuk
Mehmet T
MT
Selcuk
Hatice
H
Metin
Fatma
F
Tufekcioglu
Omac
O
Atak
Ramazan
R
Balbay
Yucel
Y
Ilkay
Erdogan
E
D000368:Aged; D017130:Angioplasty; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000503:physiopathology* / Q000601:surgery; D010343:Patient Admission; D014654:Vascular Patency