Influence of leukocytes and glycemia on the prognosis of patients with acute myocardial infarction.
BACKGROUND
Previous studies have demonstrated that leukocytosis and hyperglycemia verified at the admission of patients with acute myocardial infarction (AMI) are associated with intrahospital mortality. However, little is known on the long-term impact of these markers.


OBJECTIVE
To evaluate the short-and long-term influence of the levels of glucose and leukocytes on the prognosis of patients with AMI.


METHODS
A total of 809 patients with AMI were retrospectively assessed (mean age: 63.2 +/- 12.87 yrs) and prospectively and consecutively included in a specific database.


RESULTS
a) At the intrahospital phase, the mean values were compared between patients that died and those who survived: Leukocytosis: 12156+/-5977 vs 10337+/-3528 (p=0.004, 95%CI = 976-2663); Glucose 176+/-105 mg/dl vs 140+/-72 mg/dl (p<0.001, 95%CI = 19.4 - 52.6), respectively. b) With the adjusted mode, the same pattern was observed [p values: 0.002 (t-ratio 3.05), 0.04 (t-ratio 2.06), respectively]. c) Long-term follow-up: the univariate analysis showed P values of 0.001 (t-ratio 3.3), <0.001 (t-ratio 4.16), respectively. The multivariate analysis showed P=0.001 (t-ratio 3.35), 0.08 (t-ratio 1.75), respectively. (d) After the exclusion of the intrahospital deaths, the leukocyte (P=0.989) and glucose levels (P=0.144) did not remain significantly correlated with mortality. The same result was observed at the multivariate analysis.


CONCLUSIONS
The levels of glucose and leukocytes at the hospital admission of patients with AMI are excellent predictors of intrahospital mortality and poor predictors of long-term death.
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. eduardopesaro@hotmail.com
Antonio Eduardo P
AE
Pesaro
Jose Carlos
JC
Nicolau
Carlos V
CV
Serrano
Rodrigo
R
Truffa
Marcus Vinicius B
MV
Gaz
Ralf
R
Karbstein
Roberto R
RR
Giraldez
Roberto
R
Kalil Filho
José A
JA
Ramires
D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001938:Brazil / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000401:mortality; D007958:Leukocyte Count; D007964:Leukocytosis / Q000097:blood / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality*; D011379:Prognosis
D015415:Biomarkers; D001786:Blood Glucose