title: Relationship of admission neutrophil count to microvascular injury, left ventricular dilation, and long-term outcome in patients treated with primary angioplasty for acute myocardial infarction.
abstract: BACKGROUND
  The relationship of admission neutrophil count to the degree of microvascular injury, left ventricular (LV) volume, and long-term outcome after acute myocardial infarction (AMI) was examined in the present study.
  
  
  RESULTS
  The study group comprised 228 consecutive patients with a first anterior wall AMI who underwent primary angioplasty within 12 h of onset. The degree of microvascular injury was evaluated by Doppler guidewire. Adverse cardiac events were recorded during an average follow-up of 52+/-28 months. Using a receiver-operating characteristic analysis, a neutrophil count >or=7,260 cells/mm(3) was the best predictor of future cardiac events. By regression analysis, the neutrophil count significantly correlated with diastolic deceleration time (r=-0.40, p<0.0001), coronary flow reserve (r=-0.43, p<0.0001), and LV end-diastolic volume at 4 weeks (r=0.32, p<0.0001). Kaplan-Meier survival analysis showed a higher incidence of adverse cardiac events in patients with a high neutrophil count (p=0.002). By multivariate analysis, a neutrophil count >or=7,260 cells/mm(3) was an independent predictor of long-term adverse cardiac events (odds ratio 3.8, p=0.002).
  
  
  CONCLUSIONS
  Neutrophilia on admission is associated with impaired microvascular perfusion, LV dilation, and long-term adverse cardiac events in patients treated with primary angioplasty for AMI.
authors.affiliation: Department of Cardiology, Tokushima Red Cross Hospital, 130 Irinoguchi, Komatsushimacho, Komatsushima 773-8502, Japan. ttak@tokushima-med.jrc.or.jp
authors.forename: Takefumi
authors.initials: T
authors.lastname: Takahashi
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hiasa
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ohara
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Riyo
authors.initials: R
authors.lastname: Ogura
authors.forename: Naoki
authors.initials: N
authors.lastname: Suzuki
authors.forename: Shinobu
authors.initials: S
authors.lastname: Hosokawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Kishi
authors.forename: Ryuji
authors.initials: R
authors.lastname: Ohtani
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001783:Blood Flow Velocity; D003326:Coronary Circulation; D018572:Disease-Free Survival; D004452:Echocardiography; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000276:immunology* / Q000628:therapy*; D009504:Neutrophils / Q000166:cytology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012044:Regression Analysis; D013318:Stroke Volume; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000276:immunology / Q000628:therapy