title: White blood cell subtypes after STEMI: temporal evolution, association with cardiovascular magnetic resonance--derived infarct size and impact on outcome.
abstract: The evolution of white blood cells after ST elevation myocardial infarction (STEMI) and their association with infarct size and major adverse cardiac events (MACE) remains unclear. Two hundred eleven patients underwent CMR after STEMI. Infarct mass (grams) was determined. Neutrophil, lymphocyte, and monocyte counts (×1,000 cells/ml) were measured upon arrival and at 12, 24, 48, 72, and 96 h. Patients with large infarctions (3rd tertile ≥ 28.5 g vs. 1st and 2nd tertiles < 28.5 g) showed a larger neutrophil count at 12 h (14.8 ± 4.8 vs. 11.4 ± 3.3, p < 0.0001) and an increased monocyte count (maximum at 24 h (0.65[0.50-0.91] vs. 0.55[0.42-0.71], p = 0.004)) but no difference in lymphocyte count. Neutrophil count at 12 h independently predicted large infarctions (OR 1.14, 95%CI [1.04-1.26], p = 0.008). During follow-up (median 504 days), 25 MACE occurred. Neutrophil count at 96 h independently predicted MACE (HR 1.2, 95%CI [1.1-1.4], p = 0.003). Large infarctions show a marked neutrophil peak and an increasing monocyte count. Neutrophil count independently predicts large infarctions and MACE.
authors.affiliation: Department of Cardiology, Hospital Clinico Universitario, INCLIVA, Universidad de Valencia, Blasco Ibanez 17, Valencia, Spain.
authors.forename: Oliver
authors.initials: O
authors.lastname: Husser
authors.forename: Vicente
authors.initials: V
authors.lastname: Bodi
authors.forename: Juan
authors.initials: J
authors.lastname: Sanchis
authors.forename: Julio
authors.initials: J
authors.lastname: Nunez
authors.forename: Luis
authors.initials: L
authors.lastname: Mainar
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Chorro
authors.forename: Maria Pilar
authors.initials: MP
authors.lastname: Lopez-Lereu
authors.forename: Jose Vicente
authors.initials: JV
authors.lastname: Monmeneu
authors.forename: Fabian
authors.initials: F
authors.lastname: Chaustre
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Forteza
authors.forename: Isabel
authors.initials: I
authors.lastname: Trapero
authors.forename: Francisco
authors.initials: F
authors.lastname: Dasi
authors.forename: Isabel
authors.initials: I
authors.lastname: Benet
authors.forename: Günter A J
authors.initials: GA
authors.lastname: Riegger
authors.forename: Angel
authors.initials: A
authors.lastname: Llacer
mesh_terms: D000328:Adult; D000368:Aged; D017130:Angioplasty; D015415:Biomarkers; D006328:Cardiac Catheterization; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000502:physiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000502:physiology; D009203:Myocardial Infarction / Q000097:blood* / Q000473:pathology* / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology; D009504:Neutrophils / Q000502:physiology*; D015607:Stents; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers