title: Predictive value of postprocedural leukocyte count on myocardial perfusion, left ventricular function and clinical outcomes in ST-elevated myocardial infarction after percutaneous coronary intervention.
abstract: BACKGROUND
  Baseline white blood cell (WBC) count was correlated with ischemic events occurrence in patients with ST-elevated myocardial infarction (STEMI). However, circulating WBC count is altered after percutaneous coronary intervention (PCI). The aim of this study was to assess the relationship between postprocedural WBC count and clinical outcomes in STEMI patients who underwent PCI.
  
  
  METHODS
  A total of 242 consecutive acute STEMI patients who underwent successful primary PCI were enrolled and followed up for two years. WBC counts were measured within 12 hours after PCI. ST-segment resolution (ST-R) and myocardial blush grades (MBG) were evaluated immediately after PCI. Left ventricular ejection fraction (LVEF) was obtained at baseline and 12 - 18 months after PCI.
  
  
  RESULTS
  Postprocedural WBC count was an independent inverse predictor of ST-R (OR 0.80, P < 0.0001) and MBG 3 (OR 0.82, P < 0.0001). It was negatively correlated with LVEF (baseline r = -0.22, P = 0.001; 12 - 18 months r = -0.29, P < 0.0001). The best cutoff value of WBC for predicting death was determined to be 13.0 × 10(9)/L. The patients with a postprocedural WBC count above 13.0 × 10(9)/L showed a significantly lower cumulative survival rate (30 days, 82.4% vs. 99.0%, P < 0.0001 and 2 years 75.0% vs. 96.4%, P < 0.0001). Multivariate Cox regression analysis showed that a postprocedural WBC count was a strong independent predictor of 30-day mortality (HR 8.48, P = 0.019) and 2-year mortality (HR 4.93, P = 0.009).
  
  
  CONCLUSIONS
  Increased postprocedural WBC count is correlated with myocardial malperfusion and left ventricular dysfunction, and is an independent predictor of poor clinical outcomes in STEMI patients who underwent PCI.
authors.affiliation: Department of Cardiology, Peking University Third Hospital, Beijing 100191, China.
authors.forename: Rong
authors.initials: R
authors.lastname: He
authors.forename: Hai-yan
authors.initials: HY
authors.lastname: Li
authors.forename: Li-jun
authors.initials: LJ
authors.lastname: Guo
authors.forename: Fu-chun
authors.initials: FC
authors.lastname: Zhang
authors.forename: Jie
authors.initials: J
authors.lastname: Niu
authors.forename: Yong-zhen
authors.initials: YZ
authors.lastname: Zhang
authors.forename: Gui-song
authors.initials: GS
authors.lastname: Wang
authors.forename: Zhen-hua
authors.initials: ZH
authors.lastname: Yang
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D016896:Treatment Outcome; D016277:Ventricular Function, Left