PMID- 24753830
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140422
LR  - 20220330
IS  - 2008-5117 (Print)
IS  - 2008-6830 (Electronic)
IS  - 2008-5117 (Linking)
VI  - 6
IP  - 1
DP  - 2014
TI  - The predictive Value of Total Neutrophil Count and Neutrophil/Lymphocyte Ratio in 
      Predicting In-hospital Mortality and Complications after STEMI.
PG  - 35-41
LID - 10.5681/jcvtr.2014.007 [doi]
AB  - INTRODUCTION: Leukocytosis, predominantly neutrophilia, has previously been 
      described following ST elevation myocardial infarction (STEMI). The exact 
      contribution of this phenomenon to the clinical outcome of STEMI is yet to be 
      shown. We examined cellular inflammatory response to STEMI in the blood and its 
      association with in-hospital mortality and/or adverse clinical events. METHODS: 
      In this cross-sectional study, 404 patients who were admitted with the diagnosis 
      of acute STEMI at Madani Heart Hospital from March 2010 to March 2012 were 
      studied. The complete blood cell count (CBC) was obtained from all 
      patientswithin12-24 hours of the onset of symptoms. Total leukocytes were counted 
      and differential count was obtained for neutrophils, lymphocytes and 
      neutrophil/lymphocyte ratio (NLR) were evaluated. Association of cellular 
      response with the incidence of post-MI mortality/complications was assessed by 
      multiple logistic regression analyses. RESULTS: In-hospital mortality and 
      post-STEMI complication rate were 3.7% and 43.6%, respectively. Higher age 
      (P=0.04), female gender (0.002), lower ejection fraction (P<0.001) and absolute 
      neutrophil count (P=0.04) were predictors of mortality. Pump failure in the form 
      of acute pulmonary edema or cardiogenic shock occurred in 35 (8.9%) of patients. 
      Higher leukocyte (P<0.03) and neutrophil counts (P<0.03) and higher NLR (P=0.01) 
      were predictors of failure. The frequency of ventricular tachyarrhythmias (VT/VF) 
      at the first day was associated with higher neutrophil count (P<0.001) and higher 
      NLR level (P<0.001). In multivariate analysis neutrophil count was an independent 
      predictor of mortality (OR=2.94; 1.1-8.4, P=0.04), and neutrophil count [OR=1.1, 
      CI (1.01-1.20), P=0.02], female gender [OR=2.34, CI (1.02-4.88), P=0.04] and 
      diabetes [OR=2.52, CI (1.21-5.2), P=0.003] were independent predictors of heart 
      failure. CONCLUSION: A single CBC analysis may help to identify STEMI patients at 
      risk for mortality and heart failure, and total neutrophil count is the most 
      valuable in predicting both.
FAU - Ghaffari, Samad
AU  - Ghaffari S
AD  - Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, 
      Iran.
FAU - Nadiri, Mehdi
AU  - Nadiri M
AD  - Tohid Hospital, Sanandaj, Iran.
FAU - Pourafkari, Leili
AU  - Pourafkari L
AD  - Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, 
      Iran.
FAU - Sepehrvand, Nariman
AU  - Sepehrvand N
AD  - Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, 
      Iran.
FAU - Movasagpoor, Aliakbar
AU  - Movasagpoor A
AD  - Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, 
      Iran.
FAU - Rahmatvand, Neda
AU  - Rahmatvand N
AD  - Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, 
      Iran.
FAU - Rezazadeh Saatloo, Mohammadamin
AU  - Rezazadeh Saatloo M
AD  - Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, 
      Iran.
FAU - Ahmadi, Mona
AU  - Ahmadi M
AD  - Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, 
      Iran.
FAU - Nader, Nader D
AU  - Nader ND
AD  - VA Western New York Healthcare System, University of Buffalo, Buffalo, USA.
LA  - eng
PT  - Journal Article
DEP - 20140321
PL  - Iran
TA  - J Cardiovasc Thorac Res
JT  - Journal of cardiovascular and thoracic research
JID - 101528712
PMC - PMC3992730
OTO - NOTNLM
OT  - Acute Myocardial Infarction
OT  - Neutrophil/Lymphocyteratio
OT  - ST Segment Elevation
OT  - Total Neutrophil Count
OT  - White Blood Cell
EDAT- 2014/04/23 06:00
MHDA- 2014/04/23 06:01
PMCR- 2014/01/01
CRDT- 2014/04/23 06:00
PHST- 2013/06/07 00:00 [received]
PHST- 2014/01/02 00:00 [accepted]
PHST- 2014/04/23 06:00 [entrez]
PHST- 2014/04/23 06:00 [pubmed]
PHST- 2014/04/23 06:01 [medline]
PHST- 2014/01/01 00:00 [pmc-release]
AID - 10.5681/jcvtr.2014.007 [doi]
PST - ppublish
SO  - J Cardiovasc Thorac Res. 2014;6(1):35-41. doi: 10.5681/jcvtr.2014.007. Epub 2014 
      Mar 21.