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Relationship between leucocytosis and left ventricular ejection fraction in patients with acute myocardial infarction
Rahime Eskandarian1, Raheb Ghorbani, Zahra Asgary
1Department of Interventional Cardiology, Fatemieh Hospital, Semnan 3517894431, Iran. rheskandarian@yahoo.com
Insights
Elevated white blood cell count (leukocytosis) and neutrophil count (neutrophilia) upon admission for acute myocardial infarction (MI) predict reduced left ventricular ejection fraction (LVEF). These findings aid in risk stratification for heart failure post-MI.
Area of Science:
- Cardiology
- Internal Medicine
- Hematology
Background:
- Myocardial infarction (MI) is a leading cause of mortality, often due to arrhythmia or heart failure.
- Leukocytosis, particularly elevated neutrophils, is a known inflammatory marker in MI patients.
- The prognostic value of admission leukocytosis on left ventricular function post-MI requires further investigation.
Purpose of the Study:
- To investigate the association between admission leukocytosis and left ventricular ejection fraction (LVEF) in patients with acute myocardial infarction (AMI).
- To determine if elevated white blood cell counts predict systolic dysfunction following AMI.
Main Methods:
- A case-control study enrolled patients with AMI, matched for cardiovascular risk factors.
- Blood samples analyzed for cell counts and cardiac enzymes within 24 hours of pain onset.
- Echocardiography performed on Days 3-5 to assess LVEF; patients with LVEF < 45% defined as cases (systolic dysfunction).
Main Results:
- Leukocytosis was significantly higher in patients with left ventricular (LV) systolic dysfunction (47.8%) compared to controls (20.3%) (p = 0.001).
- Neutrophilia was also significantly more prevalent in the systolic dysfunction group (34.8%) versus controls (6.6%) (p < 0.001).
- Monocytosis showed no significant difference between groups (33.3% vs. 40.6%; p = 0.378).
Conclusions:
- Admission leukocytosis and neutrophilia are significant predictors of developing LV systolic dysfunction after acute MI.
- These hematological markers can be utilized for risk stratification in acute myocardial infarction patients.
- Early identification of patients at risk for LV dysfunction can guide timely therapeutic interventions.
Introduction:
Myocardial infarction (MI) is common and affects a significant number of people annually. Death occurs due to either arrhythmia or heart failure. As leucocytosis, especially elevated neutrophil count, is a hallmark of inflammatory reactions in patients with MI, we investigated the relationship between leucocytosis on admission and left ventricular ejection fraction (LVEF) in patients with acute MI (AMI).
Methods:
Patients with AMI were enrolled in a case-control study. Blood samples obtained in the first 24 hours after the onset of pain were analysed for cardiac enzyme levels and cell count. Echocardiography was performed on Days 3-5. Patients with LVEF < 45% were assigned to the left ventricular (LV) systolic dysfunction group (n = 69) and those with LVEF ≥ 45% were taken as controls (n = 69). All patients were matched for variables such as hypertension, diabetes mellitus, hyperlipidaemia, family history of cardiac disease, age and gender.
Results:
Leucocytosis was higher in patients with systolic dysfunction (47.8%) when compared with the controls (20.3%), and was significantly associated with the development of LV systolic dysfunction (p = 0.001). Similarly, neutrophilia was more common in patients with systolic dysfunction than the controls (6.6% vs. 34.8%), and was significantly associated with LV systolic dysfunction (p < 0.001). Monocytosis was higher in the controls than the systolic dysfunction group (40.6% vs. 33.3%; p = 0.378).
Conclusion:
Leucocytosis and neutrophilia in the acute phase of MI are important predictive factors for the development of LV systolic dysfunction. Leucocytosis can be used for risk stratification of such patients.
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