Relationship of admission hematological indexes with myocardial reperfusion abnormalities in acute ST segment elevation myocardial infarction patients treated with primary percutaneous coronary interventions

详细信息    查看全文

• 作者：Orhan Maden ; MD¹ ; ^{drorhanmaden@yahoo.co.uk} ; Fehmi Kacmaz ; MD¹ ; Hatice Selcuk ; MD¹ ; Mehmet T. Selcuk ; MD¹ ; Tolga Aksu ; MD¹ ; Omac Tufekcioglu ; MD¹ ; Emir K. Senen ; MD¹ ; Yucel Balbay ; MD¹ ; Erdogan Ilkay ; MD²
• 关键词：Leukocytes ; Platelets ; Primary percutaneous coronary intervention ; Reperfusion
• 刊名：Canadian Journal of Cardiology
• 出版年：2009
• 出版时间：June 2009
• 年：2009
• 卷：25
• 期：6
• 页码：e164-e168
• 全文大小：613 K

文摘

| ReferencesReferences

Background

Elevated values of mean platelet volume (MPV) and elevated white blood cell (WBC) count are predictors of an unfavourable outcome among survivors of ST segment elevation myocardial infarction (STEMI). However, their relationship with reperfusion abnormalities is less clear.

Objective

To evaluate the value of admission MPV and WBC count in predicting impaired reperfusion in patients with acute STEMI who are treated with primary percutaneous coronary intervention (PCI).

Methods

Blood samples were obtained on admission from 368 STEMI patients who underwent successful PCI. According to the 60th minute ST segment resolution ratio, patients were divided into impaired reperfusion and reperfusion groups.

Results

Impaired reperfusion was detected in 40 % of study patients. Patients in the impaired reperfusion group had a higher admission MPV (9.8¡À1.3 fL versus 8.6¡À1.0 fL; P<0.001) and a higher WBC count (14.4¡À5.5¡Á10⁹/L versus 12.1¡À3.8¡Á10⁹/L; P<0.001) compared with the patients in the reperfusion group. In regression analysis, MPV (OR 2.21, 95 % CI 1.69 to 2.91; P<0.001) and WBC count (OR 1.08, 95 % CI 1.02 to 1.15; P=0.01) were found to be independently associated with impaired reperfusion. The best cut-off value of MPV for predicting impaired reperfusion was determined to be 9.05 fL, with a sensitivity of 74 % and a specificity of 73 % .

Conclusions

The results indicate that leukocytes and platelets have a role in the mediation of reperfusion injury. In patients with STEMI who are undergoing PCI, admission MPV may be valuable in discriminating a higher-risk patient subgroup and thus, may help in deciding the need for adjunctive therapy to improve the outcome.