Association of non-specific inflammatory activation with early mortality in patients with ST-elevation acute coronary syndrome treated with primary angioplasty

Circ J. 2008 Feb;72(2):205-11. doi: 10.1253/circj.72.205.

Abstract

Background: The association of inflammatory markers with mortality in ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) remains controversial, so in the present study the relationships of high-sensitivity C-reactive protein (hs-CRP), total white blood cell (WBC) count, neutrophil (N) and lymphocyte (L) counts and the N/L ratio with occurrence of in-hospital mortality were assessed in patients with STEMI treated with primary PCI.

Methods and results: Inflammatory parameters were assessed on admission in 1,078 consecutive, unselected patients with STEMI admitted for primary PCI. In-hospital death occurred in 6.3% of the patients. Of the inflammatory parameters, only hs-CRP (p<0.001), and the WBC (p=0.004) and N (p=0.020) counts were predictors of death in the univariate analyses. After adjustment for other baseline clinical variables both hs-CRP and WBC count retained their independent association with mortality when analyzed both in 2 separate and in 1 multivariable models.

Conclusions: Both hs-CRP and the WBC count may independently of each other predict early outcomes in STEMI patients treated with primary PCI, which suggests different pathological significance of these 2 non-specific inflammatory markers in STEMI.

MeSH terms

  • Acute Coronary Syndrome / blood*
  • Acute Coronary Syndrome / complications
  • Acute Coronary Syndrome / mortality*
  • Acute Coronary Syndrome / therapy
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary*
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Female
  • Follow-Up Studies
  • Hospital Mortality
  • Humans
  • Inflammation Mediators / blood*
  • Leukocyte Count
  • Male
  • Middle Aged
  • Models, Cardiovascular
  • Myocardial Infarction / blood*
  • Myocardial Infarction / complications
  • Myocardial Infarction / mortality*
  • Myocardial Infarction / therapy
  • Prospective Studies

Substances

  • Biomarkers
  • Inflammation Mediators
  • C-Reactive Protein