Association of non-specific inflammatory activation with early mortality in patients with ST-elevation acute coronary syndrome treated with primary angioplasty.
BACKGROUND
The association of inflammatory markers with mortality in ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) remains controversial, so in the present study the relationships of high-sensitivity C-reactive protein (hs-CRP), total white blood cell (WBC) count, neutrophil (N) and lymphocyte (L) counts and the N/L ratio with occurrence of in-hospital mortality were assessed in patients with STEMI treated with primary PCI.


RESULTS
Inflammatory parameters were assessed on admission in 1,078 consecutive, unselected patients with STEMI admitted for primary PCI. In-hospital death occurred in 6.3% of the patients. Of the inflammatory parameters, only hs-CRP (p<0.001), and the WBC (p=0.004) and N (p=0.020) counts were predictors of death in the univariate analyses. After adjustment for other baseline clinical variables both hs-CRP and WBC count retained their independent association with mortality when analyzed both in 2 separate and in 1 multivariable models.


CONCLUSIONS
Both hs-CRP and the WBC count may independently of each other predict early outcomes in STEMI patients treated with primary PCI, which suggests different pathological significance of these 2 non-specific inflammatory markers in STEMI.
Kruk
Mariusz
M
Cathetherization Laboratory and Coronary Disease Unit, National Institute of Cardiology, Warsaw, Poland. mkruk@ikard.pl
Przyłuski
Jakub
J
Kalińczuk
Łukasz
Ł
Pregowski
Jerzy
J
Deptuch
Tomasz
T
Kadziela
Jacek
J
Bekta
Paweł
P
Karcz
Maciej
M
Demkow
Marcin
M
Chmielak
Zbigniew
Z
Witkowski
Adam
A
Ruzyłło
Witold
W
D054058:Acute Coronary Syndrome / Q000097:blood* / Q000150:complications / Q000401:mortality* / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000401:mortality* / Q000628:therapy; D011446:Prospective Studies
D015415:Biomarkers; D018836:Inflammation Mediators; D002097:C-Reactive Protein