title: The relationship between neutrophil counts on admission and angiographic no-reflow after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction.
abstract: BACKGROUND
  The no-reflow phenomenon during primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction (STEMI) can lead to poor outcomes. Increased neutrophil counts have been associated with an increased risk of adverse clinical events after acute myocardial infarction (AMI). The aim of this study was to assess the relation between admission neutrophil counts and angiographic no-reflow after PPCI.
  
  
  METHODS
  A total of 217 patients with acute STEMI who underwent PPCI, were enrolled. The patients were divided into two groups: no-reflow and normal-reflow. The neutrophil counts and other laboratory parameters were measured on admission before PPCI.
  
  
  RESULTS
  There were 41 patients (18.9%) in the no-reflow group and 176 patients in the normal-reflow group. Patients with no-reflow were older (68.0 ± 11.7 years vs 60.7 ± 13.2 years, P = 0.019) and had significantly higher admission neutrophil counts (9.02 ± 3.97 × 109/L vs 7.57 ± 2.82 × 109/L, P = 0.007). Also, high-sensitivity C-reactive protein (hsCRP), white blood counts, monocyte counts were significantly higher while haemoglobin values were significantly lower in the no-reflow group. In multivariate analysis, neutrophil counts remained a strong independent predictor of angiographic no-reflow (odds ratio 1,200, 95% confidence interval 1.073-1.342, P = 0.001) together with age (odds ratio 1.041, 95% confidence interval 1.012-1.071, P = 0.005).
  
  
  CONCLUSIONS
  Neutrophil counts on admission and age were independent clinical predictors of no-reflow following primary PCI in patients with STEMI. Our findings suggest that admission neutrophil counts may be available for early risk stratification of no-reflow after primary PCI and might allow the improvement of strategies to prevent this phenomenon.
authors.forename: Zuoyan
authors.initials: Z
authors.lastname: Wang
authors.forename: Lihui
authors.initials: L
authors.lastname: Ren
authors.forename: Licheng
authors.initials: L
authors.lastname: Lei
authors.forename: Huiming
authors.initials: H
authors.lastname: Ye
authors.forename: Jianjun
authors.initials: J
authors.lastname: Peng
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002681:China; D017023:Coronary Angiography / Q000379:methods; D003955:Diagnostic Tests, Routine / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D007958:Leukocyte Count / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000601:surgery; D009504:Neutrophils; D054318:No-Reflow Phenomenon / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000517:prevention & control; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment
keywords: Neutrophil counts; acute myocardial infarction; no-reflow phenomenon; primary percutaneous coronary intervention