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Initial serum glucose level and white blood cell predict ventricular arrhythmia after first acute myocardial
Jiann-Hwa Chen1, Chiu-Liang Tseng, Shin-Han Tsai
1Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan.
Insights
White blood cell count and serum glucose levels can predict ventricular arrhythmia (VA) in young patients experiencing their first acute myocardial infarction (AMI). These findings offer valuable insights for early risk assessment in emergency departments.
Area of Science:
- Cardiology
- Emergency Medicine
- Clinical Prediction
Background:
- Ventricular arrhythmia (VA) poses a significant risk in young patients following a first acute myocardial infarction (AMI).
- Identifying predictive factors for VA in this demographic is crucial for timely intervention and improved outcomes.
Purpose of the Study:
- To analyze predisposing factors for VA in young patients with their first AMI.
- To establish predictive implications for VA occurrence in the emergency department (ED) setting.
Main Methods:
- A 10-year retrospective cohort study involving patients aged 18-45 with a first AMI.
- Data collected from the ED of three university teaching hospitals between January 1, 1998, and December 31, 2007.
- Comparison of patient characteristics between groups with and without VA.
Main Results:
- The incidence of life-threatening VA in young patients with first AMI was 8%.
- Elevated white blood cell (WBC) count and initial serum glucose levels were significantly higher in the VA group.
- Multiple logistic regression identified WBC count and serum glucose as independent predictors of VA, with ROC areas of 0.869 and 0.756, respectively.
Conclusions:
- Initial serum glucose level and WBC count are valuable predictors for VA attack in young patients with their first AMI.
- These markers can aid in the early identification and risk stratification of young AMI patients prone to VA.
- Further research may explore incorporating these predictors into clinical decision-making tools for emergency care.
Objective:
The aims of this study are to analyze the factors that predispose the occurrence of ventricular arrhythmia (VA) in young patients with a first acute myocardial infarction (AMI) in the emergency department (ED) and to establish predictive implications.
Methods:
This is a 10-year retrospective cohort study. Patients who were older than 18 years and younger than 45 years with a first attack of AMI were recruited from the ED of 3 university teaching hospitals from January 1, 1998, to December 31, 2007.
Results:
Five hundred young patients (472 men and 28 women) who met the inclusion criteria were enrolled. Within these patients, the incidence of life-threatening VA with first attack of AMI was 8% (n = 40). They were categorized into 2 groups: VA attack (n = 40) and non-VA attack (n = 460). In univariable analyses, acute anterolateral ST-segment elevation myocardial infarction (65% vs 47.8%; P = .04), elevate white blood cell (WBC) count (16.4 +/- 3.4 vs 11.5 +/- 3.1 x 10(3)/mm(3); P < .01), and initial serum glucose level (202.6 +/- 90.9 vs 151.9 +/- 64.7 mg/dL; P < .01) were significantly increased in the VA group. Multiple logistic regression model identified WBC count and initial serum glucose level as the significant independent variables in the prediction of VA attack for young patients with first attack of AMI. The receiver operating characteristic area for WBC count and serum glucose level in predicting the risk of VA occurring after AMI was 0.869 and 0.756, respectively.
Conclusion:
Initial serum glucose level and WBC may be used as valuable predictors for VA attack in young patients with first AMI.
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