Relationship of admission neutrophil count to microvascular injury, left ventricular dilation, and long-term outcome in patients treated with primary angioplasty for acute myocardial infarction. |
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Authors: | Takefumi Takahashi Yoshikazu Hiasa Yoshikazu Ohara Shin-Ichiro Miyazaki Riyo Ogura Naoki Suzuki Shinobu Hosokawa Koichi Kishi Ryuji Ohtani |
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Institution: | Department of Cardiology, Tokushima Red Cross Hospital, 130 Irinoguchi, Komatsushimacho, Komatsushima 773-8502, Japan. ttak@tokushima-med.jrc.or.jp |
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Abstract: | BACKGROUND: The relationship of admission neutrophil count to the degree of microvascular injury, left ventricular (LV) volume, and long-term outcome after acute myocardial infarction (AMI) was examined in the present study. METHODS AND RESULTS: The study group comprised 228 consecutive patients with a first anterior wall AMI who underwent primary angioplasty within 12 h of onset. The degree of microvascular injury was evaluated by Doppler guidewire. Adverse cardiac events were recorded during an average follow-up of 52+/-28 months. Using a receiver-operating characteristic analysis, a neutrophil count >or=7,260 cells/mm(3) was the best predictor of future cardiac events. By regression analysis, the neutrophil count significantly correlated with diastolic deceleration time (r=-0.40, p<0.0001), coronary flow reserve (r=-0.43, p<0.0001), and LV end-diastolic volume at 4 weeks (r=0.32, p<0.0001). Kaplan-Meier survival analysis showed a higher incidence of adverse cardiac events in patients with a high neutrophil count (p=0.002). By multivariate analysis, a neutrophil count >or=7,260 cells/mm(3) was an independent predictor of long-term adverse cardiac events (odds ratio 3.8, p=0.002). CONCLUSION: Neutrophilia on admission is associated with impaired microvascular perfusion, LV dilation, and long-term adverse cardiac events in patients treated with primary angioplasty for AMI. |
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