Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Clinical Investigation
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
Takefumi TakahashiYoshikazu HiasaYoshikazu OharaShin-ichiro MiyazakiRiyo OguraNaoki SuzukiShinobu HosokawaKoichi KishiRyuji Ohtani
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2008 Volume 72 Issue 6 Pages 867-872

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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 ≥7,260 cells/mm3 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 ≥7,260 cells/mm3 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. (Circ J 2008; 72: 867 - 872)

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© 2008 THE JAPANESE CIRCULATION SOCIETY
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