Relationship of admission hematological indexes with myocardial reperfusion abnormalities in acute ST segment elevation myocardial infarction patients treated with primary percutaneous coronary interventions.
BACKGROUND
Elevated values of mean platelet volume (MPV) and elevated white blood cell (WBC) count are predictors of an unfavourable outcome among survivors of ST segment elevation myocardial infarction (STEMI). However, their relationship with reperfusion abnormalities is less clear.


OBJECTIVE
To evaluate the value of admission MPV and WBC count in predicting impaired reperfusion in patients with acute STEMI who are treated with primary percutaneous coronary intervention (PCI).


METHODS
Blood samples were obtained on admission from 368 STEMI patients who underwent successful PCI. According to the 60th minute ST segment resolution ratio, patients were divided into impaired reperfusion and reperfusion groups.


RESULTS
Impaired reperfusion was detected in 40% of study patients. Patients in the impaired reperfusion group had a higher admission MPV (9.8+/-1.3 fL versus 8.6+/-1.0 fL; P<0.001) and a higher WBC count (14.4+/-5.5 x 10(9)/L versus 12.1+/-3.8 x 10(9)/L; P<0.001) compared with the patients in the reperfusion group. In regression analysis, MPV (OR 2.21, 95% CI 1.69 to 2.91; P<0.001) and WBC count (OR 1.08, 95% CI 1.02 to 1.15; P=0.01) were found to be independently associated with impaired reperfusion. The best cut-off value of MPV for predicting impaired reperfusion was determined to be 9.05 fL, with a sensitivity of 74% and a specificity of 73%.


CONCLUSIONS
The results indicate that leukocytes and platelets have a role in the mediation of reperfusion injury. In patients with STEMI who are undergoing PCI, admission MPV may be valuable in discriminating a higher-risk patient subgroup and thus, may help in deciding the need for adjunctive therapy to improve the outcome.
Maden
Orhan
O
Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey. drorhanmaden@yahoo.co.uk
Kacmaz
Fehmi
F
Selcuk
Hatice
H
Selcuk
Mehmet T
MT
Aksu
Tolga
T
Tufekcioglu
Omac
O
Senen
Emir K
EK
Balbay
Yucel
Y
Ilkay
Erdogan
E
D015906:Angioplasty, Balloon, Coronary; D001792:Blood Platelets; D003955:Diagnostic Tests, Routine; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000503:physiopathology* / Q000601:surgery; D015425:Myocardial Reperfusion; D015428:Myocardial Reperfusion Injury / Q000097:blood; D012680:Sensitivity and Specificity