Biological tag effect of white blood cell count on left ventricular remodeling in patients after emergency percutaneous coronary intervention

Abstract

Objective To study the relation between white blood cell (WBC) count and left ventricular (LV) remodeling after emergency percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).Methods A total of 117 ST segment elevation AMI patients having underwent emergency PCI were enrolled.WBC count,cardiac troponin Ⅰ (cTnI),high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were obtained at admission before PCI.According to the WBC count level,patients were divided into normal WBC group (WBC count ≤ 10 ×109/L,60 cases) and elevated WBC group (WBC count ＞ 10 × 109/L,57 cases).Two-dimensional echocardiography was applied after PCI.The relation between WBC count and LV remodeling prognosis including LV ejection fraction (LVEF),LV end diastolic diameter (LVEDD) and LV aneurysm were compared after AMI.Results Admission NT-proBNP,hs-CRP and cTnI peak in elevated WBC group were higher than those in normal WBC group [ (2408.83 ± 3173.39) pg/L vs.(713.11 ± 636.82) pg/L,(39.64 ± 59.51) mg/L vs.(11.23 ± 14.14) mg/L,(107.76 ± 107.71) pg/L vs.(62.23 ± 87.79) pg/L,P ＜0.05].Admission WBC count was positively correlated with LVEDD and negatively correlated with LVEF (P ＜0.01 ).Patients with LV aneurysm had higher WBC count than those without LV aneurysm[ ( 12.59 ± 5.22) × 109/L vs. (9.27 ± 2.60) × 109/L,P =0.001 ].Multivariate analyses showed that admission WBC count ≥ 10.5 × 109/L was an independent determinant of LV aneurysm(OR =22.5,95％ CI:2.69-187.83,P ＜ 0.01 ),and this cut-off value yielded sensitivity of 76.9％ and specificity of 69.7％ respectively.Conclusion Admission WBC count may be considered as a prognostic biological tag in the prediction of the development of LV remodeling after emergency PCI in patients with AMI. Key words: Myocardial infarction; Leukocytes; Ventricular remodeling