White Blood Cell Count Predicts Infarct Size in STEMI
(HealthDay News) – For patients with anterior wall ST-segment elevated myocardial infarction (STEMI), elevated white blood cell count (WBCc) on presentation is associated with increased infarct size, according to a study published in the Dec. 15 issue of The American Journal of Cardiology.
Tullio Palmerini, MD, from Policlinico S. Orsola in Bologna, Italy, and colleagues examined whether elevated WBCc correlates with increased infarct size measured with cardiac magnetic resonance imaging 30 days after primary percutaneous coronary intervention. Data were from 407 participants with STEMI and proximal or mid-left anterior descending coronary artery occlusion from the Intracoronary Abciximab and Aspiration Thrombectomy in Patients With Large Anterior Myocardial Infarction trial. Participants were stratified according to WBCc tertiles.
The researchers observed an increase in infarct size (percentage of total left ventricular mass) at 30 days across tertiles of increasing WBCcs (median for tertiles I vs. II vs. III, 11.2% vs. 17.5% vs. 19.1%; P<0.0001). Across tertiles of WBCc, absolute infarct mass in grams and abnormal wall motion score also increased significantly. WBCc independently predicted infarct size in multivariate analysis, together with intracoronary abciximab randomization, age, time from onset of symptoms to first device, proximal left anterior descending location, and baseline Thrombolysis In Myocardial Infarction flow of 0/1.
"In conclusion, in patients with anterior wall STEMI, an elevated admission WBCc is a powerful independent predictor of infarct size measured with cardiac magnetic resonance imaging 30 days after primary percutaneous coronary intervention," the authors write.
Two authors disclosed financial ties to the medical device industry.