European Heart Journal Advance Access published online on August 21, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl191
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1 Department of Cardiovascular Disease, Ospedale Civile di Legnano, Via Candiani, 2 Legnano, Milan, Italy
* To whom correspondence should be addressed. 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.
Received July 12, 2005
Revised July 19, 2006
Accepted July 27, 2006
Clinical research
Significance of total and differential leucocyte count in patients with acute myocardial infarction treated with primary coronary angioplasty
Matteo Mariani 1 *, Raffaela Fetiveau 1, Enrico Rossetti 1, Arnaldo Poli 1, Fabrizio Poletti 1, Pietro Vandoni 1, Maurizio D'Urbano 1, Francesco Cafiero 1, Giuseppe Mariani 1, Catherine Klersy 2, and Stefano De Servi 1
2 Scientific Direction, Policlinico San Matteo, Pavia, Italy
Matteo Mariani, E-mail: mat.mariani{at}tiscali.it
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