Initial serum glucose level and white blood cell predict ventricular arrhythmia after first acute myocardial infarction.
OBJECTIVE
The aims of this study are to analyze the factors that predispose the occurrence of ventricular arrhythmia (VA) in young patients with a first acute myocardial infarction (AMI) in the emergency department (ED) and to establish predictive implications.


METHODS
This is a 10-year retrospective cohort study. Patients who were older than 18 years and younger than 45 years with a first attack of AMI were recruited from the ED of 3 university teaching hospitals from January 1, 1998, to December 31, 2007.


RESULTS
Five hundred young patients (472 men and 28 women) who met the inclusion criteria were enrolled. Within these patients, the incidence of life-threatening VA with first attack of AMI was 8% (n = 40). They were categorized into 2 groups: VA attack (n = 40) and non-VA attack (n = 460). In univariable analyses, acute anterolateral ST-segment elevation myocardial infarction (65% vs 47.8%; P = .04), elevate white blood cell (WBC) count (16.4 +/- 3.4 vs 11.5 +/- 3.1 x 10(3)/mm(3); P < .01), and initial serum glucose level (202.6 +/- 90.9 vs 151.9 +/- 64.7 mg/dL; P < .01) were significantly increased in the VA group. Multiple logistic regression model identified WBC count and initial serum glucose level as the significant independent variables in the prediction of VA attack for young patients with first attack of AMI. The receiver operating characteristic area for WBC count and serum glucose level in predicting the risk of VA occurring after AMI was 0.869 and 0.756, respectively.


CONCLUSIONS
Initial serum glucose level and WBC may be used as valuable predictors for VA attack in young patients with first AMI.
Chen
Jiann-Hwa
JH
Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan.
Tseng
Chiu-Liang
CL
Tsai
Shin-Han
SH
Chiu
Wen-Ta
WT
D000328:Adult; D001145:Arrhythmias, Cardiac / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D001786:Blood Glucose / Q000032:analysis*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D009203:Myocardial Infarction / Q000150:complications*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D014693:Ventricular Fibrillation / Q000097:blood / Q000175:diagnosis / Q000209:etiology
D001786:Blood Glucose