[Increased postprocedural neutrophil count is an independent predictive factor of poor prognosis in acute ST elevation myocardial infarction patients treated with percutaneous coronary intervention].
OBJECTIVE
The aim of the study was to evaluate the prognostic value of the postprocedural neutrophil count in patients with first acute ST elevation myocardial infarction (STEMI) treated with successful primary percutaneous coronary intervention (PCI).


METHODS
A total of 226 consecutive STEMI patients underwent successful primary PCI were enrolled. Electrocardiograms were recorded before PCI and 2 hours after PCI. Neutrophil counts were measured within 12 hours after PCI. All patients were followed up for 2 years. Logistic regression analysis was used to evaluate predictive values of postprocedural neutrophil for ST-segment resolution (STR) after PCI and for death, non-fatal myocardial infarction and heart failure at 30 days and 2 years post PCI. Time-to-event analyses were performed using the Kaplan-Meier survival curves in patients with various ranges of postprocedural neutrophil counts.


RESULTS
Postprocedural neutrophil count ranged from 2.83x10(9)/L to 18.74x10(9)/L, first quartile, median and fourth quartile were 5.66x10(9)/L, 7.38x10(9)/L and 9.34x10(9)/L respectively. Multivariable logistic analysis showed that when postprocedural neutrophil count increased 1x10(9)/L, the risk of non-STR increased 2.28 fold (OR: 2.28, P=0.009), the risk of death (OR: 1.63, P=0.010) and heart failure (OR: 1.16, P=0.035) at 30 days increased 1.63 and 1.16 folds respectively, and the risk of death (OR: 1.29, P=0.003) and heart failure (OR: 1.20, P=0.007) at 2 years increased 1.29 and 1.20 folds respectively, but the risk of non-fatal myocardial infarction was not affected by postprocedural neutrophil count. Furthermore, the patients with postprocedural neutrophil count>or=9.34x10(9)/L had significant lower 30-day (89.1% vs. 99.1% vs. 98.2%, P=0.010) and 2-year (82.4% vs. 96.1% vs. 96.3%, P=0.003) survival rates compared with the patients with postprocedural neutrophil count from 5.66x10(9)/L to 9.33x10(9)/L and the patients with postprocedural neutrophil count<5.66x10(9)/L (all P<0.05).


CONCLUSIONS
Postprocedural neutrophil count is an independent predictor of short- and long-term death and heart failure in first acute STEMI patients treated with successful primary PCI.
He
Rong
R
Department of Cardiology, Third Hospital, Peking University, Beijing 100191, China.
Yang
Zhen-hua
ZH
Li
Hai-yan
HY
Guo
Li-jun
LJ
Zhang
Fu-chun
FC
Niu
Jie
J
Zhang
Yong-zhen
YZ
Wang
Gui-song
GS
Gao
Wei
W
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D004638:Emergency Treatment / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007958:Leukocyte Count; D007964:Leukocytosis; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D009504:Neutrophils; D011379:Prognosis