Increased postprocedural neutrophil count is an independent predictive factor of poor prognosis in acute ST elevation myocardial infarction pafients treated with percutaneous coronary intervention
10.3760/cma.j.issn.0253-3758.2009.01.008
- VernacularTitle:急诊经皮冠状动脉介入治疗术后中性粒细胞升高与预后的相关性
- Author:
Rong HE
1
;
Zhen-Hua YANG
;
Hai-Yan LI
;
Ti-Jun GUO
;
Fu-Chun ZHANG
;
Jie NIU
;
Yong-Zhen ZHANG
;
Gui-Song WANG
;
Wei GAO
Author Information
1. 北京大学第三医院
- Keywords:
Myocardial infarction;
Angioplasty,transluminal,percutaneous coronary;
Neutrophils;
Prognosis
- From:
Chinese Journal of Cardiology
2009;37(1):44-48
- CountryChina
- Language:Chinese
-
Abstract:
Objeetive The aim of the study was to evaluate the prognostic vatue of the postprocedurat neutrophil count in patients with first acute ST elevation myocardial infarction(STEMI)treated with successful primary Dercutaneous coronary intervention(PCI).Metllods A total of 226 consecutive STEMI patients underwent 8uccessful primary PCI were enrolled.Electrocardiograms were recorded before PCI and 2 houm after PCI.Neutmphil counts were measured within 12 hours after PCI.All patients were followed up for 2 years.Logistic regression analysis was used to evaluate predictive values of postprocedural neutrophil for ST-segment resolution(STR)after PCI and for death,non-fatal myocardial infarction and heart failure at 30 days and 2 years post PCI.Time-to-event analyses were performed using the Kaplan-Meier survivat curves in patients with various ranges of postprocedural neutrophil counts.ResultsPostprocedurat neutrophil count ranged from 2.83×109/L to 18.74 x 109/L,first quartile,median and fourth quartile were 5.66×109/L,7.38×109/L and 9.34×109/L respectively.Muhivariable logistic analysis showed that when postprocedural neutrophil count increased 1×109/L,the risk of non-STR increased 2.28 fold(OR:2.28,P=0.009),the risk of death(OR:1.63,P=0.010)and heart failure (OR:1.16.P=0.035)at 30 days increased 1.63 and 1.16 folds respectively,and the risk of death(OR:1.29,P=0.003)and heart failure(OR:1.20,P=0.007)at 2 years increased 1.29 and 1.20 folds respectively,but the risk of non-fatal myocardial infaretion was not affected by postprocedural neutrophil count.Furthermore,the patients with postproeedural neutrophil count≥9.34×109/L had significant lower 30-day(89.1%vs.99.1%vs.98.2%,P=0.010)and 2-year(82.4%vs.96.1%vs.96.3%,P=0.003)SUrvival rates compared with the patients with postprocedural neutrophil count from 5.66×109/L to 9.33×109/L and the patients with postprocedural neutrophil count＜5.66×109/L(all P＜0.05).Conclusion Postprocedural neutrophil count is an independent predictor of short-and long-term death and heart failure in first acute STEMI patients treated with successful primary PCI.
