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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

White blood cell count and the occurrence of silent ischemia after myocardial infarction

Małgorzata Kurpesa1, Ewa Trzos, Maria Krzemińska-Pakuła

  • 1Department of Cardiology, Institute of Medicine, Medical University of Łódź, Poland. kurpesa@ptkardio.pl

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|July 10, 2003
PubMed

Insights

Asymptomatic patients post-myocardial infarction with elevated white blood cell (WBC) counts show a higher likelihood of residual ischemia. This finding highlights WBC count as a key indicator for silent ischemia after heart attack.

Area of Science:

  • Cardiology
  • Inflammation research
  • Diagnostic markers

Background:

  • Inflammation is implicated in atherosclerosis development.
  • Inflammatory markers are explored as prognostic factors in coronary artery disease and acute coronary syndromes.
  • The relationship between inflammation and silent postinfarction ischemia remains unclear.

Purpose of the Study:

  • To investigate the correlation between white blood cell (WBC) count, an indicator of inflammation, and the presence of silent ischemia in asymptomatic patients after Q-wave myocardial infarction.
  • To determine if elevated WBC count is an independent predictor of residual ischemia.

Main Methods:

  • 104 asymptomatic patients with recent Q-wave myocardial infarction were enrolled.
  • Patients were stratified into two groups based on white blood cell (WBC) count (< or = 7.0 x 103/microl and > 7.0 x 103/microl).
  • Twenty-four-hour Holter monitoring was used to detect silent ischemic episodes.

Main Results:

  • Silent ischemia was detected in 84% of patients with elevated WBC count versus 9% in the lower WBC count group (P < 0.01).
  • A significant positive correlation was observed between WBC count and the number, amplitude, duration, and total burden of ischemic episodes.
  • Multivariate analysis identified leucocytosis (elevated WBC count) as the sole independent predictor of silent ischemia.

Conclusions:

  • Postinfarction patients who are asymptomatic but have an increased white blood cell (WBC) count are at higher risk for residual ischemia.
  • Elevated WBC count serves as a significant indicator for the presence of silent ischemia in the post-myocardial infarction period.
Abstract

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