Impact of white blood cell count on myocardial salvage, infarct size, and clinical outcomes in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction

A magnetic resonance imaging study

Seungmin Chung, Young Bin Song, Joo Yong Hahn, Sung A. Chang, Sang Chol Lee, Yeon Hyeon Choe, Seung Hyuk Choi, Jin Ho Choi, Sang Hoon Lee, Jae Kuen Oh, Hyeon Cheol Gwon

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

We sought to determine the relationship between white blood cell count (WBCc) and infarct size assessed by cardiovascular magnetic resonance imaging (CMR) in patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). In 198 patients undergoing primary PCI for STEMI, WBCc was measured upon arrival and CMR was performed a median of 7 days after the index event. Infarct size was measured on delayed enhancement imaging and the area at risk (AAR) was quantified on T2-weighted images. Baseline characteristics were not significantly different between the high WBCc group (>11,000/mm3, n = 91) and low WBCc group (≤11,000/mm3, n = 107). The median infarct size was larger in the high WBCc group than in the low WBCc group [22.0% (16.7-33.9) vs. 14.7% (8.5-24.7), p < 0.01]. Compared with the low WBCc group, the high WBCc group had a greater extent of AAR and a smaller myocardial salvage index [MSI = (AAR- infarct size)/AAR x 100]. The major adverse cardiovascular events (MACE) including cardiac death, nonfatal reinfarction, and rehospitalization for congestive heart failure at 12-month occurred more frequently in the high WBCc group (12.1 vs. 0.9%, p < 0.01). In multivariate analysis, high WBCc significantly increased the risk of a large infarct (OR 3.04 95% CI 1.65-5.61, p < 0.01), a low MSI (OR 2.08, 95%CI 1.13-3.86, p = 0.02), and 1-year MACE (OR 16.0, 95% CI 1.89-134.5, p = 0.01). In patients undergoing primary PCI for STEMI, an elevated baseline WBCc is associated with less salvaged myocardium, larger infarct size and poorer clinical outcomes.

Original languageEnglish (US)
Pages (from-to)129-136
Number of pages8
JournalInternational Journal of Cardiovascular Imaging
Volume30
Issue number1
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Percutaneous Coronary Intervention
Leukocyte Count
Myocardial Infarction
Magnetic Resonance Imaging
ST Elevation Myocardial Infarction
Myocardium
Multivariate Analysis
Heart Failure

Keywords

  • Magnetic resonance imaging
  • Myocardial infarction
  • White blood cell

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Impact of white blood cell count on myocardial salvage, infarct size, and clinical outcomes in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction : A magnetic resonance imaging study. / Chung, Seungmin; Song, Young Bin; Hahn, Joo Yong; Chang, Sung A.; Lee, Sang Chol; Choe, Yeon Hyeon; Choi, Seung Hyuk; Choi, Jin Ho; Lee, Sang Hoon; Oh, Jae Kuen; Gwon, Hyeon Cheol.

In: International Journal of Cardiovascular Imaging, Vol. 30, No. 1, 2014, p. 129-136.

Research output: Contribution to journalArticle

Chung, Seungmin ; Song, Young Bin ; Hahn, Joo Yong ; Chang, Sung A. ; Lee, Sang Chol ; Choe, Yeon Hyeon ; Choi, Seung Hyuk ; Choi, Jin Ho ; Lee, Sang Hoon ; Oh, Jae Kuen ; Gwon, Hyeon Cheol. / Impact of white blood cell count on myocardial salvage, infarct size, and clinical outcomes in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction : A magnetic resonance imaging study. In: International Journal of Cardiovascular Imaging. 2014 ; Vol. 30, No. 1. pp. 129-136.
@article{0471f3953636446ca6a3c77207338bb6,
title = "Impact of white blood cell count on myocardial salvage, infarct size, and clinical outcomes in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: A magnetic resonance imaging study",
abstract = "We sought to determine the relationship between white blood cell count (WBCc) and infarct size assessed by cardiovascular magnetic resonance imaging (CMR) in patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). In 198 patients undergoing primary PCI for STEMI, WBCc was measured upon arrival and CMR was performed a median of 7 days after the index event. Infarct size was measured on delayed enhancement imaging and the area at risk (AAR) was quantified on T2-weighted images. Baseline characteristics were not significantly different between the high WBCc group (>11,000/mm3, n = 91) and low WBCc group (≤11,000/mm3, n = 107). The median infarct size was larger in the high WBCc group than in the low WBCc group [22.0{\%} (16.7-33.9) vs. 14.7{\%} (8.5-24.7), p < 0.01]. Compared with the low WBCc group, the high WBCc group had a greater extent of AAR and a smaller myocardial salvage index [MSI = (AAR- infarct size)/AAR x 100]. The major adverse cardiovascular events (MACE) including cardiac death, nonfatal reinfarction, and rehospitalization for congestive heart failure at 12-month occurred more frequently in the high WBCc group (12.1 vs. 0.9{\%}, p < 0.01). In multivariate analysis, high WBCc significantly increased the risk of a large infarct (OR 3.04 95{\%} CI 1.65-5.61, p < 0.01), a low MSI (OR 2.08, 95{\%}CI 1.13-3.86, p = 0.02), and 1-year MACE (OR 16.0, 95{\%} CI 1.89-134.5, p = 0.01). In patients undergoing primary PCI for STEMI, an elevated baseline WBCc is associated with less salvaged myocardium, larger infarct size and poorer clinical outcomes.",
keywords = "Magnetic resonance imaging, Myocardial infarction, White blood cell",
author = "Seungmin Chung and Song, {Young Bin} and Hahn, {Joo Yong} and Chang, {Sung A.} and Lee, {Sang Chol} and Choe, {Yeon Hyeon} and Choi, {Seung Hyuk} and Choi, {Jin Ho} and Lee, {Sang Hoon} and Oh, {Jae Kuen} and Gwon, {Hyeon Cheol}",
year = "2014",
doi = "10.1007/s10554-013-0303-x",
language = "English (US)",
volume = "30",
pages = "129--136",
journal = "International Journal of Cardiovascular Imaging",
issn = "1569-5794",
publisher = "Springer Netherlands",
number = "1",

}

TY - JOUR

T1 - Impact of white blood cell count on myocardial salvage, infarct size, and clinical outcomes in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction

T2 - A magnetic resonance imaging study

AU - Chung, Seungmin

AU - Song, Young Bin

AU - Hahn, Joo Yong

AU - Chang, Sung A.

AU - Lee, Sang Chol

AU - Choe, Yeon Hyeon

AU - Choi, Seung Hyuk

AU - Choi, Jin Ho

AU - Lee, Sang Hoon

AU - Oh, Jae Kuen

AU - Gwon, Hyeon Cheol

PY - 2014

Y1 - 2014

N2 - We sought to determine the relationship between white blood cell count (WBCc) and infarct size assessed by cardiovascular magnetic resonance imaging (CMR) in patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). In 198 patients undergoing primary PCI for STEMI, WBCc was measured upon arrival and CMR was performed a median of 7 days after the index event. Infarct size was measured on delayed enhancement imaging and the area at risk (AAR) was quantified on T2-weighted images. Baseline characteristics were not significantly different between the high WBCc group (>11,000/mm3, n = 91) and low WBCc group (≤11,000/mm3, n = 107). The median infarct size was larger in the high WBCc group than in the low WBCc group [22.0% (16.7-33.9) vs. 14.7% (8.5-24.7), p < 0.01]. Compared with the low WBCc group, the high WBCc group had a greater extent of AAR and a smaller myocardial salvage index [MSI = (AAR- infarct size)/AAR x 100]. The major adverse cardiovascular events (MACE) including cardiac death, nonfatal reinfarction, and rehospitalization for congestive heart failure at 12-month occurred more frequently in the high WBCc group (12.1 vs. 0.9%, p < 0.01). In multivariate analysis, high WBCc significantly increased the risk of a large infarct (OR 3.04 95% CI 1.65-5.61, p < 0.01), a low MSI (OR 2.08, 95%CI 1.13-3.86, p = 0.02), and 1-year MACE (OR 16.0, 95% CI 1.89-134.5, p = 0.01). In patients undergoing primary PCI for STEMI, an elevated baseline WBCc is associated with less salvaged myocardium, larger infarct size and poorer clinical outcomes.

AB - We sought to determine the relationship between white blood cell count (WBCc) and infarct size assessed by cardiovascular magnetic resonance imaging (CMR) in patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). In 198 patients undergoing primary PCI for STEMI, WBCc was measured upon arrival and CMR was performed a median of 7 days after the index event. Infarct size was measured on delayed enhancement imaging and the area at risk (AAR) was quantified on T2-weighted images. Baseline characteristics were not significantly different between the high WBCc group (>11,000/mm3, n = 91) and low WBCc group (≤11,000/mm3, n = 107). The median infarct size was larger in the high WBCc group than in the low WBCc group [22.0% (16.7-33.9) vs. 14.7% (8.5-24.7), p < 0.01]. Compared with the low WBCc group, the high WBCc group had a greater extent of AAR and a smaller myocardial salvage index [MSI = (AAR- infarct size)/AAR x 100]. The major adverse cardiovascular events (MACE) including cardiac death, nonfatal reinfarction, and rehospitalization for congestive heart failure at 12-month occurred more frequently in the high WBCc group (12.1 vs. 0.9%, p < 0.01). In multivariate analysis, high WBCc significantly increased the risk of a large infarct (OR 3.04 95% CI 1.65-5.61, p < 0.01), a low MSI (OR 2.08, 95%CI 1.13-3.86, p = 0.02), and 1-year MACE (OR 16.0, 95% CI 1.89-134.5, p = 0.01). In patients undergoing primary PCI for STEMI, an elevated baseline WBCc is associated with less salvaged myocardium, larger infarct size and poorer clinical outcomes.

KW - Magnetic resonance imaging

KW - Myocardial infarction

KW - White blood cell

UR - http://www.scopus.com/inward/record.url?scp=84898861230&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84898861230&partnerID=8YFLogxK

U2 - 10.1007/s10554-013-0303-x

DO - 10.1007/s10554-013-0303-x

M3 - Article

VL - 30

SP - 129

EP - 136

JO - International Journal of Cardiovascular Imaging

JF - International Journal of Cardiovascular Imaging

SN - 1569-5794

IS - 1

ER -