Hemoglobin, Leukocytosis and Clinical Outcomes of ST-Elevation Myocardial Infarction Treated With Primary Angioplasty Anin Myocardial Infarction Registry

Mariusz Kruk; Jakub Przyluski; Lukasz Kalinczuk; Jerzy Pregowski; Jacek Kadziela; Edyta Kaczmarska; Joanna Petryka; Cezary Kepka; Mariusz Klopotowski; Zbigniew Chmielak; Andrzej Ciszewski; Marcin Demkow; Maciej Karcz; Adam Witkowski; Witold Ruzyllo

doi:10.1253/circj.CJ-08-0370

Ischemic Heart Disease

Hemoglobin, Leukocytosis and Clinical Outcomes of ST-Elevation Myocardial Infarction Treated With Primary Angioplasty

Anin Myocardial Infarction Registry

Mariusz Kruk, Jakub Przyluski, Lukasz Kalinczuk, Jerzy Pregowski, Jacek Kadziela, Edyta Kaczmarska, Joanna Petryka, Cezary Kepka, Mariusz Klopotowski, Zbigniew Chmielak, Andrzej Ciszewski, Marcin Demkow, Maciej Karcz, Adam Witkowski, Witold Ruzyllo

Author information

Mariusz Kruk
Cathetherization Laboratory and Coronary Disease Unit, Institute of Cardiology
Jakub Przyluski
Cathetherization Laboratory and Coronary Disease Unit, Institute of Cardiology
Lukasz Kalinczuk
Cathetherization Laboratory and Coronary Disease Unit, Institute of Cardiology
Jerzy Pregowski
Cathetherization Laboratory and Coronary Disease Unit, Institute of Cardiology
Jacek Kadziela
Cathetherization Laboratory and Coronary Disease Unit, Institute of Cardiology
Edyta Kaczmarska
Cathetherization Laboratory and Coronary Disease Unit, Institute of Cardiology
Joanna Petryka
Cathetherization Laboratory and Coronary Disease Unit, Institute of Cardiology
Cezary Kepka
Cathetherization Laboratory and Coronary Disease Unit, Institute of Cardiology
Mariusz Klopotowski
Cathetherization Laboratory and Coronary Disease Unit, Institute of Cardiology
Zbigniew Chmielak
Cathetherization Laboratory and Coronary Disease Unit, Institute of Cardiology
Andrzej Ciszewski
Cathetherization Laboratory and Coronary Disease Unit, Institute of Cardiology
Marcin Demkow
Cathetherization Laboratory and Coronary Disease Unit, Institute of Cardiology
Maciej Karcz
Cathetherization Laboratory and Coronary Disease Unit, Institute of Cardiology
Adam Witkowski
Cathetherization Laboratory and Coronary Disease Unit, Institute of Cardiology
Witold Ruzyllo
Cathetherization Laboratory and Coronary Disease Unit, Institute of Cardiology

Keywords: Hemoglobin, Inflammation, Leukocytes, Myocardial infarction, Primary angioplasty

JOURNAL FREE ACCESS

2009 Volume 73 Issue 2 Pages 323-329

DOI https://doi.org/10.1253/circj.CJ-08-0370

View "Advance Publication" version (December 24, 2008).

Details

Abstract

Background Hemoglobin (Hb) levels may interact with inflammatory activation, but it is unknown whether the interaction has any impact on clinical outcomes in acute coronary syndromes. The aim of this study was to assess the relationship between admission Hb levels, leukocytosis and clinical outcomes of ST-elevation myocardial infarction (STEMI) treated with primary angioplasty. Methods and Results The study group comprised 1,904 (1,380 men) patients with STEMI treated with primary percutaneous coronary intervention, enrolled in a prospective registry. The primary endpoint of in-hospital death occurred in 90 (4.7%) patients. According to univariate analysis, extreme values of Hb (for 1^st and 5^th vs mid quintiles respectively: hazard ratio (HR) =7.1, P<0.001 and HR =3.2, P=0.024) and leukocytosis above median (HR =2.09, P=0.001) significantly correlated with in-hospital death. After dividing patients into high and low white blood cell (WBC) count groups, a U-shaped relationship of Hb levels and mortality was observed for patients with higher leukocytosis (1^st and 5^th vs mid quintiles respectively: HR =8.1, P=0.001 and HR =4.4, P=0.022), whereas in patients with lower WBC count higher mortality was related solely to the lowest Hb quintile (HR =6.9, P=0.010 vs mid quintile). Conclusion Higher mortality associated with higher Hb levels in STEMI patients treated with primary angioplasty is limited to patients with increased leukocytosis. (Circ J 2009; 73: 323 - 329)

Corresponding author

Register with J-STAGE for free!