title: Combined prognostic utility of white blood cell count, plasma glucose, and glomerular filtration rate in patients undergoing primary stent placement for acute myocardial infarction.
abstract: Although high white blood cell (WBC) count and plasma glucose (PG) and low glomerular filtration rate (GFR) on admission have been associated with poor outcomes after acute myocardial infarction (AMI), the combined prognostic utility of these 3 variables was unclear. The association of WBC count, PG, and GFR on admission to in-hospital outcomes was examined in 2,633 patients who underwent primary stent placement for ST-segment elevation AMI within 48 hours after symptom onset. In-hospital mortality progressively increased as the number of the variables of high WBC count (> or =11,120/microl; upper tertile), high PG (> or =10.4 mmol/L; upper tertile), and low GFR (< or =60 ml/min/1.73 m(2); lower tertile) increased. Patients with all 3 variables had a strikingly higher in-hospital mortality rate (25.9%). After adjusting for baseline characteristics, multivariate analysis showed that compared with patients who had none of these variables, odds ratios for in-hospital mortality were 1.63 (95% confidence interval [CI] 0.88 to 3.03, p = 0.12) in patients with only 1 variable, 2.33 (95% CI 1.28 to 3.96, p = 0.047) in those with 2 variables, and 6.16 (95% CI 2.98 to 12.6, p <0.001) in those with all 3 variables. In conclusion, combined evaluation of WBC count, PG, and GFR on admission was a simple and useful method for the early prediction of risk of in-hospital death in patients undergoing primary stent placement for ST-segment elevation AMI.
authors.affiliation: Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Kosuge
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morita
authors.forename: Sunao
authors.initials: S
authors.lastname: Kojima
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishihara
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Asada
authors.forename: Chuwa
authors.initials: C
authors.lastname: Tei
authors.forename: Shunichi
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sonoda
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Tsuchihashi
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
authors.forename: Mutsunori
authors.initials: M
authors.lastname: Shirai
authors.forename: Hisatoyo
authors.initials: H
authors.lastname: Hiraoka
authors.forename: Takashi
authors.initials: T
authors.lastname: Honda
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ogata
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001786:Blood Glucose / Q000032:analysis*; D005260:Female; D005919:Glomerular Filtration Rate; D017052:Hospital Mortality; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011379:Prognosis; D015607:Stents
chemical_list: D001786:Blood Glucose