European Heart Journal Advance Access originally published online on August 21, 2006
European Heart Journal 2006 27(21):2511-2515; doi:10.1093/eurheartj/ehl191
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Significance of total and differential leucocyte count in patients with acute myocardial infarction treated with primary coronary angioplasty
1 Department of Cardiovascular Disease, Ospedale Civile di Legnano, Via Candiani, 2 Legnano, Milan, Italy
2 Scientific Direction, Policlinico San Matteo, Pavia, Italy
Received 12 July 2005; revised 19 July 2006; accepted 27 July 2006; online publish-ahead-of-print 21 August 2006.
* Corresponding author. Tel: +39 (0) 331 449513; fax: +39 (0) 331 449810. E-mail address: mat.mariani{at}tiscali.it
See page 2487 for the editorial comment on this article (doi:10.1093/eurheartj/ehl267)
Aims The aim of this study was to correlate total and differential leucocyte (WBC) count with myocardial blush, peak CK levels, and left ventricular (LV) functional recovery at 6 months in 238 consecutive acute myocardial infarction (MI) patients treated with successful primary coronary angioplasty (PCI).
Methods and results Total and differential WBC counts were measured on admission and every 24 h for at least 4 days after PCI. ST-segment resolution and myocardial blush were evaluated immediately after successful primary PCI. LV functional recovery (defined as improvement involving at least two segments, or at least one segment, when only two were asynergic on the basal examination) was obtained through echocardiographic evaluation of LV wall motion at the baseline and at 6 months. Basal CK (P<0.001) and increased neutrophil levels (P<0.001) were the only independent factors related to peak CK, whereas neutrophils and monocytes peaks were related to ST-segment resolution as well as to myocardial blush grade (MBG) 2–3. MBG 2–3 and monocytes number (both as continuous values as well as percentile values) were the only variables independently associated with 6-month LV functional recovery.
Conclusion The present study shows that neutrophils and monocytes counts on the first days after acute MI treated with primary PCI are related to markers of effective myocardial reperfusion such as MBG 2–3 and ST-segment resolution. However, only monocytes and MBG are significantly and independently associated with contractile recovery of the infarcted area at 6 months.
Key Words: Leucocytes • Myocardial infarction • Inflammation
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