Leukocytosis as The Short-Term Predictor for Mortality in Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention

Abstract

Background: In daily clinical practice, leukocyte count is the most common and simple inflammation parameter. Moreover, its role in predicting acute coronary syndrome (ACS) patients' clinical outcomes and prognosis is still conflicting. This study aimed to assess the role of leukocytosis as the predictor of mortality in ACS patients undergoing percutaneous coronary intervention (PCI). Method: This single-center retrospective cohort study used the STEMI registry data in Saiful Anwar General Hospital, Malang, Indonesia, from January to July 2019. The exposure was the leucocyte count during hospital admission and the outcome was the 30-day mortality following PCI procedure. The receiver-operating characteristic (ROC) curve was used to determine leucocyte count cut-off pint, sensitivity, and specificity. Result: The best leukocyte count cut-off value was 12300/µL, with the area under the curve (AUC) of 0.702 (95% CI 0.575 - 0.83), sensitivity of 71.4%, and specificity of 61.3%. Leukocytosis increased the risk of 30-day mortality (74.5% vs 42.4%; OR = 3.958; 95% CI = 1.518-10.25; p = 0.014). Survival rate within 30-day after PCI was lowered in leukocytosis group (the Log-Rank p = 0.002). The difference became apparent after day five post-PCI. Conclusion: Leukocytosis during hospital admission is associated with increased mortality in ACS patients undergoing PCI. Leucocytosis is a good predictor of mortality within 30 days after PCI in this population. Keywords: leukocytosis, acute coronary syndrome, percutaneous coronary intervention, mortality

Value of Hematological and Coagulation Parameters as Prognostic Factors in Acute Coronary Syndromes

“…WBC and NEU were found to have an acceptable discriminative power for predicting ventricular rhythm disturbances in ACS patients and in patients treated with PCI. Rahimi et al in a multicenter study revealed that the only predictor for malignant ventricular arrhythmia in NSTEMI patients treated with early invasive strategy was WBC [29].…”