Peripheral blood leukocyte count and prognosis in patients with myocardial infarction treated with thrombolytic therapy
Journal Title: Серце і судини - Year 2019, Vol 0, Issue 1
Abstract
The aim — to evaluate the predictive value of peripheral blood leukocyte count regarding the efficacy of thrombolytic therapy (TLT) and STEMI clinical course. Materials and methods. We examined 100 patients with STEMI admitted to hospital during the first 6 hours after anginous chest pain onset and treated with TLT. In 12 ± 2 months after study entry, the information about complications during follow‑up period was collected and cardiac ultrasound was repeated. TLT efficacy was evaluated according to ST segment dynamics on ECG directly before TLT and in 180 min after its initiation. TLT was considered effective in case of ST segment reduction ≥ 50 %. Results and discussion. Median of leukocyte count was 10.8 · 109/L. Patients were divided into two groups: group I consisted of patients with leukocyte count ≤ 10.8 · 109/L, group II — of patients with leukocyte count > 10.8 · 109/L. Patients in group II were more likely to have anterior MI localization (р = 0.03). They had higher maximum MB‑creatinine phosphokinase (р = 0.001) and higher C‑reactive protein level at hospitalization (р = 0.03). In the acute period of myocardial infarction patients of the 2nd group had a statistically significantly higher complication rate (χ2 = 7.77; p = 0.005), and after 1 year of observation — a greater risk of adverse events (χ2 = 5.66; p = 0.02) and a smaller ejection fraction (p = 0.009). A correlation was revealed between the level of leukocytes of the maximum value of MB‑creatinine phosphokinase (r = +0.42; p < 0.001) and the echocardiogram indices in the long‑term period, in particular, the end‑diastolic volume of the left ventricle (r = +0.41; p = 0.007), end‑systolic volume of the left ventricle (r = +0.51; p < 0.001), left ventricular ejection fraction (r = –0.50; p < 0.001), myocardium mass of the left ventricle (r = +0.35; p = 0, 03). By the method of ROC analysis, the predictor value of the content of leukocytes relative to the efficiency of CLT was established using a cut‑off point of 11.0 · 109/L. Conclusions. The initial amount of leukocytes in the peripheral blood of more than 10.8 · 109/L in patients with acute coronary syndrome with ST segment elevation, who underwent TLT, is associated with a higher volume of myocardial damage, a higher risk of complications in the acute and distant MI. The number of white blood cells ≥ 11 · 109/L is associated with insufficient efficiency of TLT.
Authors and Affiliations
V. I. Tseluyko, O. E. Matuzok, N. Y. Mishchuk, L. M. Yakovleva
Keywords
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- EP ID EP563160
- DOI 10.30978/HV2019-1-53
- Views 139
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