Relation between white blood cell count and final infarct size in patients with ST-segment elevation acute myocardial infarction undergoing primary percutaneous coronary intervention (from the INFUSE AMI trial)

Tullio Palmerini, Sorin J. Brener, Philippe Genereux, Akiko Maehara, Diego Della Riva, Andrea Mariani, Bernhard Witzenbichler, Jacek Godlewski, Helen Parise, Jan Henk E. Dambrink, Andrzej Ochala, Martin Fahy, Ke Xu, C. Michael Gibson, Gregg W. Stone

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Although it has been shown that elevated white blood cell count (WBCc) on presentation is associated with an increased risk of cardiac mortality in patients with ST-segment elevation myocardial infarction (STEMI), the responsible mechanisms are unknown. We therefore sought to investigate whether elevated WBCc is associated with increased infarct size measured with cardiac magnetic resonance imaging 30 days after primary percutaneous coronary intervention in the Intracoronary Abciximab and Aspiration Thrombectomy in Patients With Large Anterior Myocardial Infarction trial. INFUSE AMI randomized patients with STEMI and proximal or mid-left anterior descending coronary artery occlusion to bolus intracoronary abciximab versus no abciximab and to manual aspiration versus no aspiration. WBCc at hospital admission was available in 407 of 452 randomized patients. Patients were stratified according to tertiles of WBCc. At 30 days, a significant stepwise increase in infarct size (percentage of total left ventricular mass) was apparent across tertiles of increasing WBCc (median [interquartile range] for tertiles I vs II vs III = 11.2% [3.8% to 19.6%] vs 17.5% [0.5% to 22.9%] vs 19.1% [13.7 to 26.0], respectively, p <0.0001). Absolute infarct mass in grams and abnormal wall motion score were also significantly increased across tertiles of WBC. By multivariate linear regression analysis, WBCc was an independent predictor of infarct size along with intracoronary abciximab randomization, age, time from symptom onset to first device, proximal left anterior descending location, and baseline TIMI flow of 0/1. In conclusion, in patients with anterior wall STEMI, an elevated admission WBCc is a powerful independent predictor of infarct size measured with cardiac magnetic resonance imaging 30 days after primary percutaneous coronary intervention.

Original languageEnglish (US)
Pages (from-to)1860-1866
Number of pages7
JournalAmerican Journal of Cardiology
Volume112
Issue number12
DOIs
StatePublished - Dec 15 2013

Fingerprint

Percutaneous Coronary Intervention
Leukocyte Count
Myocardial Infarction
Magnetic Resonance Imaging
Thrombectomy
Coronary Occlusion
Random Allocation
ST Elevation Myocardial Infarction
Linear Models
Coronary Vessels
Regression Analysis
Equipment and Supplies
Mortality
abciximab

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Palmerini, Tullio ; Brener, Sorin J. ; Genereux, Philippe ; Maehara, Akiko ; Della Riva, Diego ; Mariani, Andrea ; Witzenbichler, Bernhard ; Godlewski, Jacek ; Parise, Helen ; Dambrink, Jan Henk E. ; Ochala, Andrzej ; Fahy, Martin ; Xu, Ke ; Gibson, C. Michael ; Stone, Gregg W. / Relation between white blood cell count and final infarct size in patients with ST-segment elevation acute myocardial infarction undergoing primary percutaneous coronary intervention (from the INFUSE AMI trial). In: American Journal of Cardiology. 2013 ; Vol. 112, No. 12. pp. 1860-1866.
@article{3a365753062549b78ae382ebedf0c74a,
title = "Relation between white blood cell count and final infarct size in patients with ST-segment elevation acute myocardial infarction undergoing primary percutaneous coronary intervention (from the INFUSE AMI trial)",
abstract = "Although it has been shown that elevated white blood cell count (WBCc) on presentation is associated with an increased risk of cardiac mortality in patients with ST-segment elevation myocardial infarction (STEMI), the responsible mechanisms are unknown. We therefore sought to investigate whether elevated WBCc is associated with increased infarct size measured with cardiac magnetic resonance imaging 30 days after primary percutaneous coronary intervention in the Intracoronary Abciximab and Aspiration Thrombectomy in Patients With Large Anterior Myocardial Infarction trial. INFUSE AMI randomized patients with STEMI and proximal or mid-left anterior descending coronary artery occlusion to bolus intracoronary abciximab versus no abciximab and to manual aspiration versus no aspiration. WBCc at hospital admission was available in 407 of 452 randomized patients. Patients were stratified according to tertiles of WBCc. At 30 days, a significant stepwise increase in infarct size (percentage of total left ventricular mass) was apparent across tertiles of increasing WBCc (median [interquartile range] for tertiles I vs II vs III = 11.2{\%} [3.8{\%} to 19.6{\%}] vs 17.5{\%} [0.5{\%} to 22.9{\%}] vs 19.1{\%} [13.7 to 26.0], respectively, p <0.0001). Absolute infarct mass in grams and abnormal wall motion score were also significantly increased across tertiles of WBC. By multivariate linear regression analysis, WBCc was an independent predictor of infarct size along with intracoronary abciximab randomization, age, time from symptom onset to first device, proximal left anterior descending location, and baseline TIMI flow of 0/1. In conclusion, in patients with anterior wall STEMI, an elevated admission WBCc is a powerful independent predictor of infarct size measured with cardiac magnetic resonance imaging 30 days after primary percutaneous coronary intervention.",
author = "Tullio Palmerini and Brener, {Sorin J.} and Philippe Genereux and Akiko Maehara and {Della Riva}, Diego and Andrea Mariani and Bernhard Witzenbichler and Jacek Godlewski and Helen Parise and Dambrink, {Jan Henk E.} and Andrzej Ochala and Martin Fahy and Ke Xu and Gibson, {C. Michael} and Stone, {Gregg W.}",
year = "2013",
month = "12",
day = "15",
doi = "10.1016/j.amjcard.2013.08.010",
language = "English (US)",
volume = "112",
pages = "1860--1866",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "12",

}

Palmerini, T, Brener, SJ, Genereux, P, Maehara, A, Della Riva, D, Mariani, A, Witzenbichler, B, Godlewski, J, Parise, H, Dambrink, JHE, Ochala, A, Fahy, M, Xu, K, Gibson, CM & Stone, GW 2013, 'Relation between white blood cell count and final infarct size in patients with ST-segment elevation acute myocardial infarction undergoing primary percutaneous coronary intervention (from the INFUSE AMI trial)', American Journal of Cardiology, vol. 112, no. 12, pp. 1860-1866. https://doi.org/10.1016/j.amjcard.2013.08.010

Relation between white blood cell count and final infarct size in patients with ST-segment elevation acute myocardial infarction undergoing primary percutaneous coronary intervention (from the INFUSE AMI trial). / Palmerini, Tullio; Brener, Sorin J.; Genereux, Philippe; Maehara, Akiko; Della Riva, Diego; Mariani, Andrea; Witzenbichler, Bernhard; Godlewski, Jacek; Parise, Helen; Dambrink, Jan Henk E.; Ochala, Andrzej; Fahy, Martin; Xu, Ke; Gibson, C. Michael; Stone, Gregg W.

In: American Journal of Cardiology, Vol. 112, No. 12, 15.12.2013, p. 1860-1866.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Relation between white blood cell count and final infarct size in patients with ST-segment elevation acute myocardial infarction undergoing primary percutaneous coronary intervention (from the INFUSE AMI trial)

AU - Palmerini, Tullio

AU - Brener, Sorin J.

AU - Genereux, Philippe

AU - Maehara, Akiko

AU - Della Riva, Diego

AU - Mariani, Andrea

AU - Witzenbichler, Bernhard

AU - Godlewski, Jacek

AU - Parise, Helen

AU - Dambrink, Jan Henk E.

AU - Ochala, Andrzej

AU - Fahy, Martin

AU - Xu, Ke

AU - Gibson, C. Michael

AU - Stone, Gregg W.

PY - 2013/12/15

Y1 - 2013/12/15

N2 - Although it has been shown that elevated white blood cell count (WBCc) on presentation is associated with an increased risk of cardiac mortality in patients with ST-segment elevation myocardial infarction (STEMI), the responsible mechanisms are unknown. We therefore sought to investigate whether elevated WBCc is associated with increased infarct size measured with cardiac magnetic resonance imaging 30 days after primary percutaneous coronary intervention in the Intracoronary Abciximab and Aspiration Thrombectomy in Patients With Large Anterior Myocardial Infarction trial. INFUSE AMI randomized patients with STEMI and proximal or mid-left anterior descending coronary artery occlusion to bolus intracoronary abciximab versus no abciximab and to manual aspiration versus no aspiration. WBCc at hospital admission was available in 407 of 452 randomized patients. Patients were stratified according to tertiles of WBCc. At 30 days, a significant stepwise increase in infarct size (percentage of total left ventricular mass) was apparent across tertiles of increasing WBCc (median [interquartile range] for tertiles I vs II vs III = 11.2% [3.8% to 19.6%] vs 17.5% [0.5% to 22.9%] vs 19.1% [13.7 to 26.0], respectively, p <0.0001). Absolute infarct mass in grams and abnormal wall motion score were also significantly increased across tertiles of WBC. By multivariate linear regression analysis, WBCc was an independent predictor of infarct size along with intracoronary abciximab randomization, age, time from symptom onset to first device, proximal left anterior descending location, and baseline TIMI flow of 0/1. In conclusion, in patients with anterior wall STEMI, an elevated admission WBCc is a powerful independent predictor of infarct size measured with cardiac magnetic resonance imaging 30 days after primary percutaneous coronary intervention.

AB - Although it has been shown that elevated white blood cell count (WBCc) on presentation is associated with an increased risk of cardiac mortality in patients with ST-segment elevation myocardial infarction (STEMI), the responsible mechanisms are unknown. We therefore sought to investigate whether elevated WBCc is associated with increased infarct size measured with cardiac magnetic resonance imaging 30 days after primary percutaneous coronary intervention in the Intracoronary Abciximab and Aspiration Thrombectomy in Patients With Large Anterior Myocardial Infarction trial. INFUSE AMI randomized patients with STEMI and proximal or mid-left anterior descending coronary artery occlusion to bolus intracoronary abciximab versus no abciximab and to manual aspiration versus no aspiration. WBCc at hospital admission was available in 407 of 452 randomized patients. Patients were stratified according to tertiles of WBCc. At 30 days, a significant stepwise increase in infarct size (percentage of total left ventricular mass) was apparent across tertiles of increasing WBCc (median [interquartile range] for tertiles I vs II vs III = 11.2% [3.8% to 19.6%] vs 17.5% [0.5% to 22.9%] vs 19.1% [13.7 to 26.0], respectively, p <0.0001). Absolute infarct mass in grams and abnormal wall motion score were also significantly increased across tertiles of WBC. By multivariate linear regression analysis, WBCc was an independent predictor of infarct size along with intracoronary abciximab randomization, age, time from symptom onset to first device, proximal left anterior descending location, and baseline TIMI flow of 0/1. In conclusion, in patients with anterior wall STEMI, an elevated admission WBCc is a powerful independent predictor of infarct size measured with cardiac magnetic resonance imaging 30 days after primary percutaneous coronary intervention.

UR - http://www.scopus.com/inward/record.url?scp=84888602804&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84888602804&partnerID=8YFLogxK

U2 - 10.1016/j.amjcard.2013.08.010

DO - 10.1016/j.amjcard.2013.08.010

M3 - Article

VL - 112

SP - 1860

EP - 1866

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 12

ER -