Lower mean corpuscular hemoglobin concentration is associated with poorer outcomes in intensive care unit admitted patients with acute myocardial infarction.
BACKGROUND
Accumulated studies have shown that hematological parameters [e.g., red blood cell distribution width (RDW), hemoglobin, platelet count] and serum potassium level can impact the prognosis of patients with acute myocardial infarction (AMI). However, no previous study has evaluated the prognostic values of these laboratory tests simultaneously.


METHODS
This study is based on an intensive care unit (ICU) database named Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC II). Adult patients with AMI were included, and their hematological parameters and serum ion levels on admission were extracted. The relationships between these laboratory tests and hospital mortality were evaluated using a logistic regression model and receiver operating characteristic (ROC) curve analysis. The effects of these laboratory tests on 1-year mortality were evaluated using a Cox hazard regression model and Kaplan-Meier curve analysis.


RESULTS
In univariable analysis, increased white blood cell (WBC), neutrophil percentage, mean corpuscular volume (MCV), RDW, potassium and decreased red blood cell (RBC), hemoglobin, mean corpuscular hemoglobin concentration (MCHC), hematocrit and percentage of lymphocyte, monocyte, basophil and eosinophil were significantly associated with hospital mortality. In multivariable analyses, basophil percentage, potassium, WBC and MCHC were independently associated with hospital morality, while WBC, RDW, MCHC, potassium and percentages of neutrophil and lymphocyte were associated with 1-year mortality.


CONCLUSIONS
Hematological parameters and serum potassium can provide prognostic information in AMI patients. MCHC is an independent prognostic factor for both short and long term outcomes of AMI.
1 Department of Laboratory Medicine, No. 455 Hospital of the Chinese People's Liberation Army, Shanghai 200052, China ; 2 Department of Laboratory Medicine, the General Hospital of Ji'nan Military Command Region, Ji'nan 250031, China.
Yuan-Lan
YL
Huang
1 Department of Laboratory Medicine, No. 455 Hospital of the Chinese People's Liberation Army, Shanghai 200052, China ; 2 Department of Laboratory Medicine, the General Hospital of Ji'nan Military Command Region, Ji'nan 250031, China.
Zhi-De
ZD
Hu
Acute myocardial infarction (AMI); hematological parameter; mean corpuscular hemoglobin concentration (MCHC); potassium; prognosis