Neutrophil count on admission predicts major in-hospital events in patients with a non-ST-segment elevation acute coronary syndrome.
BACKGROUND
Inflammation plays a key role in the pathogenesis of acute coronary syndromes (ACS). In this context we assessed neutrophil count as a predictor of major in-hospital events in patients admitted for a non-ST-segment elevation (NSTE) ACS.


METHODS
We measured neutrophils on admission in 160 patients with a NSTE ACS and we correlated their count with the incidence of a combined in-hospital end point including: cardiac death, acute heart failure, ST-segment elevation myocardial infarction, and recurrent myocardial ischemia.


RESULTS
Patients who had a major in-hospital event also had a higher neutrophil count (P = 0.02) and higher serum levels of troponin I (P = 0.04). In the univariate logistic regression analysis, in-hospital major events could be predicted by troponin I > 0.07 ng/mL (odds ratio [OR]: 5.65, 95% confidence interval [CI]: 1.26-25.32, P = 0.02), white blood cell count > 8650 cells/microL (OR: 2.68, 95% CI: 1.03-6.95, P = 0.04), neutrophil count > 6700 cells/microL (OR: 7.74, 95% CI: 2.79-21.47, P < 0.001), and C-reactive protein > 0.97 mg/dL (OR: 3.56, 95% CI: 1.13-11.19, P = 0.02). However, in multivariate regression, neutrophil count > 6700 cells/microL (OR: 6.52, 95% CI: 1.56-27.22, P = 0.01) was the only independent in-hospital prognostic factor.


CONCLUSIONS
In patients with a NSTE ACS of moderate or high risk, neutrophil count on admission may identify those who are at risk of having an adverse in-hospital outcome.
Karabinos
Ilias
I
Euroclinic of Athens Greece, Athens, Greece. ilias.karabinos@lycos.com
Koulouris
Spyridon
S
Kranidis
Athanasios
A
Pastromas
Socrates
S
Exadaktylos
Nikolaos
N
Kalofoutis
Anastasios
A
D054058:Acute Coronary Syndrome / Q000097:blood* / Q000150:complications* / Q000401:mortality / Q000628:therapy; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000209:etiology; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology; D009504:Neutrophils; D016017:Odds Ratio; D010343:Patient Admission; D011237:Predictive Value of Tests; D012372:ROC Curve; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood
D015415:Biomarkers; D019210:Troponin I