Núñez Julio, Fácila Lorenzo, Llàcer Angel, Sanchís Juan, Bodí Vicent, Bertomeu Vicente, Sanjuán Rafael, Blasco María L, Consuegra Luciano, Bosch María J, Chorro Francisco J
Servei de Cardiología, Hospital Clínic i Universitari, Universitat de València, Valencia, Spain.
Rev Esp Cardiol. 2005 Jun;58(6):631-9.
Although traditionally an elevated white blood cell count (WBC), an indicator of systemic inflammation, has been accepted as part of the healing response following acute myocardial infarction (AMI), it has frequently been shown to be a predictor of adverse cardiovascular events. The present study was designed to assess the association between WBC and long-term mortality in AMI patients either with ST-segment elevation (STEMI) or without ST-segment elevation (non-STEMI). Patients and method. The study included 1118 consecutive patients who were admitted with the diagnosis of AMI: 569 non-STEMI and 549 STEMI. The WBC was measured in the 24 hours following admission. Patients were divided into 3 groups: WBC1 (count, <10 x 103 cells/mL), WBC2 (count, 10-14.9 x 10(3) cells/mL), and WBC3 (count, > or =15x10(3) cells/mL). All-cause mortality was recorded during a median follow-up period of 10+/-2 months. The relationship between WBC and mortality was assessed by Cox regression analysis for both types of AMI.
Long-term mortality during follow-up was 18.5% in non-STEMI patients and 19.9% in STEMI patients. In non-STEMI patients, the adjusted hazard ratios for those in the WBC3 and WBC2 groups compared with those in the WBC1 group were 2.07 (1.08-3.94; P=.027) and 1.61 (1.03-2.51; P=.036), respectively. The corresponding figures in STEMI patients were 2.07 (1.13-3.76; P=.017) and 2.22 (1.35-3.63; P=.002), respectively.
WBC on admission was an independent predictor of long-term mortality in both non-STEMI and STEMI patients.
传统上，白细胞计数（WBC）升高作为全身炎症的一个指标，被认为是急性心肌梗死（AMI）后愈合反应的一部分，但它经常被证明是不良心血管事件的一个预测指标。本研究旨在评估ST段抬高型心肌梗死（STEMI）或非ST段抬高型心肌梗死（非STEMI）的AMI患者中白细胞与长期死亡率之间的关联。
患者与方法。该研究纳入了1118例连续诊断为AMI的患者：569例非STEMI患者和549例STEMI患者。入院后24小时内测量白细胞计数。患者被分为3组：WBC1组（计数，<10×10³个细胞/毫升）、WBC2组（计数，10 - 14.9×10³个细胞/毫升）和WBC3组（计数，≥15×10³个细胞/毫升）。在中位随访期10±2个月期间记录全因死亡率。通过Cox回归分析评估两种类型AMI中白细胞与死亡率之间的关系。
随访期间，非STEMI患者的长期死亡率为18.5%，STEMI患者为19.9%。在非STEMI患者中，与WBC1组相比，WBC3组和WBC2组的校正风险比分别为2.07（1.08 - 3.94；P = 0.027）和1.61（1.03 - 2.51；P = 0.036）。STEMI患者的相应数字分别为2.07（1.13 - 3.76；P = 0.017）和2.22（1.35 - 3.63；P = 0.002）。
入院时的白细胞是预测非STEMI和STEMI患者长期死亡率的独立因素。
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