Combined prognostic utility of white blood cell count, plasma glucose, and glomerular filtration rate in patients undergoing primary stent placement for acute myocardial infarction.
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.
Kosuge
Masami
M
Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Kimura
Kazuo
K
Morita
Satoshi
S
Kojima
Sunao
S
Sakamoto
Tomohiro
T
Ishihara
Masaharu
M
Asada
Yujiro
Y
Tei
Chuwa
C
Miyazaki
Shunichi
S
Sonoda
Masahiro
M
Tsuchihashi
Kazufumi
K
Yamagishi
Masakazu
M
Shirai
Mutsunori
M
Hiraoka
Hisatoyo
H
Honda
Takashi
T
Ogata
Yasuhiro
Y
Ogawa
Hisao
H
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
D001786:Blood Glucose