title: Effect of Hematologic Parameters on Microvascular Reperfusion in Patients With ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention.
abstract: OBJECTIVE
  Despite the significant role of certain hematologic parameters in reperfusion injury, their relationship with microvascular reperfusion remains not well understood. Therefore, our objective was to evaluate the relationship between hematologic parameters at admission and microvascular reperfusion in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (primary PCI).
  
  
  METHODS
  A total of 213patients (mean age: 57.5 ± 11 years) with STEMI were included. Blood samples were obtained from all patients prior to primary PCI. Electrocardiographic recordings were made for the evaluation of ST-segment resolution (STR) before and after primary PCI. Angiographic assessment in the infarct-related artery was performed using the myocardial blush grade (MBG) and thrombolysis in myocardial infarction (TIMI) flow. Patients were categorized into 2 groups as those with impaired microvascular reperfusion (STR <70%, TIMI: 0-1, and MBG: 0-1) and those with normal microvascular reperfusion (STR >70%, TIMI: 2-3, and MBG: 2-3).
  
  
  RESULTS
  Of the overall study group, 139, 105, and 69 patients had an STR of <70%, MBG of 0-1, and TIMI of 0-1, respectively. Demographic parameters in both groups are shown in the tables. Patients with impaired microvascular reperfusion were found to have higher white blood cell (WBC) count, neutrophil count, lymphocyte count, and mean platelet volume (MPV). Neutrophil-lymphocyte ratio and platelet count were similar between the 2 groups. Correlation analysis showed a negative correlation between lymphocyte count and STR (r: -.195, P: .004), lymphocyte count and TIMI flow(r: -.09, P: .14), and lymphocyte count and MBG (r: -.211, P: .002).
  
  
  CONCLUSIONS
  Our results suggest that higher WBC count and MPV at admission are independent predictors of impaired microvascular perfusion in patients with STEMI. On the other hand, a negative correlation was found between lymphocyte count and impaired microvascular perfusion. Specifically, elevated lymphocyte count seemed to indicate the presence of impaired microvascular reperfusion in patients with STEMI.
authors.affiliation: Department of Cardiology, Gazi Yasargil Education and Research Hospital, Diyarbakır, Turkey zerkif@mynet.com.
authors.forename: Zülküf
authors.initials: Z
authors.lastname: Karahan
authors.affiliation: Department of Cardiology, Gazi Yasargil Education and Research Hospital, Diyarbakır, Turkey.
authors.forename: Berzal
authors.initials: B
authors.lastname: Uçaman
authors.affiliation: Department of Cardiology, Gazi Yasargil Education and Research Hospital, Diyarbakır, Turkey.
authors.forename: Ali Veysel
authors.initials: AV
authors.lastname: Uluğ
authors.affiliation: Department of Cardiology, Gazi Yasargil Education and Research Hospital, Diyarbakır, Turkey.
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Aydınalp
authors.affiliation: Department of Cardiology, Gazi Yasargil Education and Research Hospital, Diyarbakır, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Uğurlu
authors.affiliation: Department of Cardiology, Gazi Yasargil Education and Research Hospital, Diyarbakır, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Çevik
authors.affiliation: Department of Cardiology, Gazi Yasargil Education and Research Hospital, Diyarbakır, Turkey.
authors.forename: İlyas
authors.initials: İ
authors.lastname: Kaya
authors.affiliation: Department of Cardiology, Gazi Yasargil Education and Research Hospital, Diyarbakır, Turkey.
authors.forename: Önder
authors.initials: Ö
authors.lastname: Öztürk
mesh_terms: D000368:Aged; D001792:Blood Platelets; D017023:Coronary Angiography; D003326:Coronary Circulation; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D007962:Leukocytes; D008297:Male; D063847:Mean Platelet Volume; D008833:Microcirculation; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D055414:Myocardial Perfusion Imaging / Q000379:methods; D015428:Myocardial Reperfusion Injury / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D010343:Patient Admission; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome
keywords: hematologic parameters; microvascular reperfusion; myocardial infarction; primary percutaneous coronary intervention