Poster No. 109 Prognostic value of white blood cell count variation during in-hospital stay in STEMI patients: Insights from SCALIM Registry

Abstract

Abstract Background In patients with ST-elevation myocardial infarction (STEMI), white blood cell count (WBCC) is associated with infarct size and cardiovascular outcome. We sought to determine the impact of WBBC variation (?WBCC) during in-hospital stay on long-term outcome after STEMI. Methods From 2011 to 2019, consecutive patients with STEMI were enrolled. Those with at least two WBCC during hospitalization were included in this study. ?WBCC was calculated as: [WBCC (admission) – WBCC (before discharge)]. The population was divided into 3 groups according to ?WBCC tertiles. The primary outcome was total mortality. Results A total of 1778 patients (mean age 64.5 ± 14.1, 75.7% males), were included and divided in 3 groups: Group 1 (?WBCC < 0.85 103/mm3); Group 2 (?WBCC 0.85–3.31 103/mm3); and Group 3 (?WBCC > 3.31 103/mm3). Patients in Group 1 were the oldest (67.9 ± 13.8, vs. 65.1 ± 13.9 and 60.5 ± 13.7 years in Groups 2 and 3 respectively, P < 0.001). Hypertension, prior coronary artery bypass and cancer were more prevalent in Groups 1 and 2. Troponin peak was the highest in Group 3 (3601 ± 563) than Group 2 and 3 (2810 ± 439 and 2451 ± 467 ng/ml, respectively; P < 0.001). Five-year survival was the lowest in Group 1 (78.6% vs. 87.2% and 87.5% in Group 2 and 3, respectively; P < 0.001). Adjusted to age, gender, cardiovascular risk factors, MI territory and left ventricular ejection fraction, ?WBCC < 0.85. 103/mm3 was independently associated with all-cause mortality [HR 1.46; 95%CI 1.12–1.91; P = 0.005]. Conclusion ?WBCC < 850/mm3 Is associated with increased mortality. Low ?WBCC during hospitalization could represent an interesting prognostic tool in STEMI patients.